| Wellness On The Horizon, Llc | |
|
712 E Empire St Bloomington IL 61701-3252 | |
| (309) 532-4572 | |
| Not Available |
| Full Name | Wellness On The Horizon, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 712 E Empire St, Bloomington, Illinois |
| Authorized Official Name and Position | Laurie Krolikowski (CEO) |
| Authorized Official Contact | 3095324572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness On The Horizon, Llc 712 E Empire St Bloomington IL 61701-3252 Ph: (309) 532-4572 | Wellness On The Horizon, Llc 712 E Empire St Bloomington IL 61701-3252 Ph: (309) 532-4572 |
| NPI Number | 1336601202 |
|---|---|
| Provider Enumeration Date | 04/01/2019 |
| Last Update Date | 07/11/2019 |
| Medicare PECOS PAC ID | 8022345255 |
|---|---|
| Medicare Enrollment ID | O20190812001751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336601202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laurie Krolikowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023551306 PECOS PAC ID: 9133496565 Enrollment ID: I20170606001582 |
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