| Jaycar Wellness Group Llc | |
|
47 Carriage Way Ypsilanti MI 48197-7430 | |
| (734) 757-0308 | |
| Not Available |
| Full Name | Jaycar Wellness Group Llc |
|---|---|
| Speciality | Social Worker |
| Location | 47 Carriage Way, Ypsilanti, Michigan |
| Authorized Official Name and Position | Jearald Dudley (OWNER) |
| Authorized Official Contact | 7347570308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaycar Wellness Group Llc 47 Carriage Way Ypsilanti MI 48197-7430 Ph: (734) 757-0308 | Jaycar Wellness Group Llc 47 Carriage Way Ypsilanti MI 48197-7430 Ph: (734) 757-0308 |
| NPI Number | 1427769215 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 4082084975 |
|---|---|
| Medicare Enrollment ID | O20230111000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427769215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jearald Dudley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851908636 PECOS PAC ID: 5991175887 Enrollment ID: I20230117000164 |
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