| Ken Adolph Wellness, Llc | |
|
2911 Medical Arts St Ste 19a Austin TX 78705-3329 | |
| (512) 686-5935 | |
| (737) 242-9997 |
| Full Name | Ken Adolph Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2911 Medical Arts St Ste 19a, Austin, Texas |
| Authorized Official Name and Position | Howard Kenneth Adolph (FOUNDER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 5127501348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ken Adolph Wellness, Llc 4901 Avenue H Austin TX 78751-2530 Ph: (512) 585-9594 | Ken Adolph Wellness, Llc 2911 Medical Arts St Ste 19a Austin TX 78705-3329 Ph: (512) 686-5935 |
| NPI Number | 1396347514 |
|---|---|
| Provider Enumeration Date | 11/12/2020 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396347514 | NPI | - | NPPES |
| 1215901368 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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