| Innovative Health & Wellness Llc 2 | |
|
2300 Humbug Creek Rd Jacksonville OR 97530-9617 | |
| (702) 522-7363 | |
| Not Available |
| Full Name | Innovative Health & Wellness Llc 2 |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2300 Humbug Creek Rd, Jacksonville, Oregon |
| Authorized Official Name and Position | Carlos R Pollard (CEO) |
| Authorized Official Contact | 7023242126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Health & Wellness Llc 2 2300 Humbug Creek Rd Jacksonville OR 97530-9617 Ph: (702) 522-7363 | Innovative Health & Wellness Llc 2 2300 Humbug Creek Rd Jacksonville OR 97530-9617 Ph: (702) 522-7363 |
| NPI Number | 1598373870 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598373870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
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