| Re:create Joy, Llc | |
|
308 Glines Ct Harrison AR 72601-4416 | |
| (417) 293-1933 | |
| Not Available |
| Full Name | Re:create Joy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 308 Glines Ct, Harrison, Arkansas |
| Authorized Official Name and Position | Angela M. Pereira (OWNER/THERAPIST) |
| Authorized Official Contact | 4172931933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Re:create Joy, Llc 308 Glines Ct Harrison AR 72601-4416 Ph: (417) 293-1933 | Re:create Joy, Llc 308 Glines Ct Harrison AR 72601-4416 Ph: (417) 293-1933 |
| NPI Number | 1043833197 |
|---|---|
| Provider Enumeration Date | 05/23/2020 |
| Last Update Date | 05/23/2020 |
| Certification Date | 05/23/2020 |
| Medicare PECOS PAC ID | 8325460595 |
|---|---|
| Medicare Enrollment ID | O20200616003023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043833197 | NPI | - | NPPES |
| Provider Name | Angela M Pereira |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730599275 PECOS PAC ID: 2365350212 Enrollment ID: I20170530002014 |
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