Wellness Etc Llc | |
1133 W Mill Rd Ste 200 Evansville IN 47710-3877 | |
(821) 480-0778 | |
Not Available |
Full Name | Wellness Etc Llc |
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Speciality | Clinic/Center |
Location | 1133 W Mill Rd Ste 200, Evansville, Indiana |
Authorized Official Name and Position | Sasha Kendall (OWNER) |
Authorized Official Contact | 8124800778 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Wellness Etc Llc 1133 W Mill Rd Ste 200 Evansville IN 47710-3877 Ph: (821) 480-0778 | Wellness Etc Llc 1133 W Mill Rd Ste 200 Evansville IN 47710-3877 Ph: (821) 480-0778 |
NPI Number | 1265068084 |
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Provider Enumeration Date | 03/13/2020 |
Last Update Date | 03/24/2020 |
Certification Date | 03/24/2020 |
Medicare PECOS PAC ID | 9739519984 |
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Medicare Enrollment ID | O20200430002259 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265068084 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Sasha Rose Kendall |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1619244381 PECOS PAC ID: 8426371832 Enrollment ID: I20141216000306 |
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