| One Love Periodic Services, Inc | |
|
451 N Main St Marion NC 28752-3304 | |
| (828) 559-0414 | |
| Not Available |
| Full Name | One Love Periodic Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 451 N Main St, Marion, North Carolina |
| Authorized Official Name and Position | Stevie Lynn Wideman (CEO) |
| Authorized Official Contact | 8284334567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Love Periodic Services, Inc 100 Queen St Morganton NC 28655-3440 Ph: (828) 433-4567 | One Love Periodic Services, Inc 451 N Main St Marion NC 28752-3304 Ph: (828) 559-0414 |
| NPI Number | 1346519014 |
|---|---|
| Provider Enumeration Date | 12/23/2011 |
| Last Update Date | 01/16/2020 |
| Certification Date | 01/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346519014 | NPI | - | NPPES |
| 8703220 | Medicaid | NC | |
| 5916270 | Medicaid | NC | |
| 8301457V | Medicaid | NC | |
| 3410218 | Medicaid | NC | |
| 6008242 | Medicaid | NC | |
| 8301457H | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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