| Pacem Wellness, Llc | |
|
8 Eagle Ctr Ste 12 O Fallon IL 62269-1947 | |
| (317) 451-9298 | |
| Not Available |
| Full Name | Pacem Wellness, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8 Eagle Ctr Ste 12, O Fallon, Illinois |
| Authorized Official Name and Position | Renata B Sledge (OWNER) |
| Authorized Official Contact | 3179655944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacem Wellness, Llc 1329 Pepperidge Dr O Fallon IL 62269-3041 Ph: (317) 965-5944 | Pacem Wellness, Llc 8 Eagle Ctr Ste 12 O Fallon IL 62269-1947 Ph: (317) 451-9298 |
| NPI Number | 1942817150 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 5597163782 |
|---|---|
| Medicare Enrollment ID | O20211001000424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942817150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Renata B Sledge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194342170 PECOS PAC ID: 9335559269 Enrollment ID: I20201104002910 |
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