Thrive4wholeness Llc | |
33 Murray Guard Dr Jackson TN 38305-3610 | |
(731) 410-7719 | |
(731) 214-1816 |
Full Name | Thrive4wholeness Llc |
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Speciality | Social Worker |
Location | 33 Murray Guard Dr, Jackson, Tennessee |
Authorized Official Name and Position | Elizabeth Wilson (OWNER/OPERATOR) |
Authorized Official Contact | 7314107719 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thrive4wholeness Llc 33 Murray Guard Dr Jackson TN 38305-3610 Ph: (731) 410-7719 | Thrive4wholeness Llc 33 Murray Guard Dr Jackson TN 38305-3610 Ph: (731) 410-7719 |
NPI Number | 1346927050 |
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Provider Enumeration Date | 07/04/2023 |
Last Update Date | 07/04/2023 |
Certification Date | 07/03/2023 |
Medicare PECOS PAC ID | 0749634426 |
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Medicare Enrollment ID | O20230928003154 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346927050 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Elizabeth E Wilson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437799012 PECOS PAC ID: 7810326550 Enrollment ID: I20200401002223 |
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