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7877 S Hwy 89-91 Wellsville UT 84339 | |
(385) 440-7050 | |
(385) 240-6215 |
Full Name | |
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Speciality | Substance Abuse Rehabilitation Facility |
Location | 7877 S Hwy 89-91, Wellsville, Utah |
Authorized Official Name and Position | Jessica Darling (MANAGING PARTNER) |
Authorized Official Contact | 8017317757 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 440 Wellsville UT 84339-0440 Ph: (385) 440-7048 | 7877 S Hwy 89-91 Wellsville UT 84339 Ph: (385) 440-7050 |
NPI Number | 1891451712 |
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Provider Enumeration Date | 11/15/2021 |
Last Update Date | 09/16/2022 |
Certification Date | 09/16/2022 |
Medicare PECOS PAC ID | 2466837687 |
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Medicare Enrollment ID | O20220923000586 |
Identifier | Type | State | Issuer |
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1891451712 | NPI | - | NPPES |
Provider Name | Terrell L Sellers |
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Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1033373865 PECOS PAC ID: 1254388135 Enrollment ID: I20050402000042 |