| Nurture Wholeness, Llc | |
|
309 Wisconsin Ave Whitefish MT 59937-2319 | |
| (406) 209-8450 | |
| Not Available |
| Full Name | Nurture Wholeness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 309 Wisconsin Ave, Whitefish, Montana |
| Authorized Official Name and Position | Patricia D Kennelly (PRESIDENT) |
| Authorized Official Contact | 4062098450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurture Wholeness, Llc 15 Montana Ave Whitefish MT 59937-2224 Ph: (406) 209-8450 | Nurture Wholeness, Llc 309 Wisconsin Ave Whitefish MT 59937-2319 Ph: (406) 209-8450 |
| NPI Number | 1588014492 |
|---|---|
| Provider Enumeration Date | 06/21/2016 |
| Last Update Date | 06/21/2016 |
| Medicare PECOS PAC ID | 9931488848 |
|---|---|
| Medicare Enrollment ID | O20161117000662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588014492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12305 (Montana) | Primary |
| Provider Name | Patricia D Kennelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679958706 PECOS PAC ID: 0345556254 Enrollment ID: I20150908001626 |
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