| Wellmore Centre Llc | |
|
204 2nd St Ne New Philadelphia OH 44663-2808 | |
| (234) 801-2469 | |
| Not Available |
| Full Name | Wellmore Centre Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 2nd St Ne, New Philadelphia, Ohio |
| Authorized Official Name and Position | Mark Andrew Welty (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3307046998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmore Centre Llc 204 2nd St Ne New Philadelphia OH 44663-2808 Ph: (234) 801-2469 | Wellmore Centre Llc 204 2nd St Ne New Philadelphia OH 44663-2808 Ph: (234) 801-2469 |
| NPI Number | 1487150470 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 03/28/2022 |
| Certification Date | 03/28/2022 |
| Medicare PECOS PAC ID | 9234536046 |
|---|---|
| Medicare Enrollment ID | O20210921003583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487150470 | NPI | - | NPPES |
| Provider Name | Nanette E Davenport Roberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730395138 PECOS PAC ID: 6406253160 Enrollment ID: I20210922001939 |
| Provider Name | Mark A Welty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942320858 PECOS PAC ID: 9032516851 Enrollment ID: I20240410003038 |
| Provider Name | Robert Draman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902093149 PECOS PAC ID: 9931641107 Enrollment ID: I20240604002165 |
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