Luna Wellness Llc | |
404 Hamilton Rd Ste 4 Wapakoneta OH 45895-1156 | |
(419) 739-7002 | |
Not Available |
Full Name | Luna Wellness Llc |
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Speciality | Clinic/Center |
Location | 404 Hamilton Rd Ste 4, Wapakoneta, Ohio |
Authorized Official Name and Position | Gloria Marie Esquivel-lynch (OWNER/CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 4197397002 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Luna Wellness Llc Po Box 62 Wapakoneta OH 45895-0062 Ph: () - | Luna Wellness Llc 404 Hamilton Rd Ste 4 Wapakoneta OH 45895-1156 Ph: (419) 739-7002 |
NPI Number | 1518588441 |
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Provider Enumeration Date | 05/01/2020 |
Last Update Date | 05/30/2021 |
Certification Date | 05/30/2021 |
Medicare PECOS PAC ID | 1456774074 |
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Medicare Enrollment ID | O20200714003542 |
Identifier | Type | State | Issuer |
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1518588441 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Gloria M Esquivel Lynch |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1922185206 PECOS PAC ID: 5092759845 Enrollment ID: I20200714003672 |
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