| Center For Acceptance And Wellness P.c | |
|
168 Sw Court St Dallas OR 97338-3105 | |
| (503) 751-1222 | |
| (503) 751-1229 |
| Full Name | Center For Acceptance And Wellness P.c |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 168 Sw Court St, Dallas, Oregon |
| Authorized Official Name and Position | Kim Maria Cansino (OWNER) |
| Authorized Official Contact | 7472585004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Acceptance And Wellness P.c 141 Sw Newton Dr Dallas OR 97338-9038 Ph: (747) 258-5004 | Center For Acceptance And Wellness P.c 168 Sw Court St Dallas OR 97338-3105 Ph: (503) 751-1222 |
| NPI Number | 1598535320 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Medicare PECOS PAC ID | 5193265239 |
|---|---|
| Medicare Enrollment ID | O20240904002751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598535320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Kim Maria Cansino |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780017327 PECOS PAC ID: 7810437951 Enrollment ID: I20240904003237 |
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