| Wellness & Transformation Llc | |
|
4249 E State St Ste 201 Rockford IL 61108-2045 | |
| (224) 704-0909 | |
| Not Available |
| Full Name | Wellness & Transformation Llc |
|---|---|
| Speciality | Counselor |
| Location | 4249 E State St Ste 201, Rockford, Illinois |
| Authorized Official Name and Position | Cristina Gloria (OWNER) |
| Authorized Official Contact | 2247040909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness & Transformation Llc 3512 Springwheat Rockford IL 61114-5649 Ph: (224) 704-0909 | Wellness & Transformation Llc 4249 E State St Ste 201 Rockford IL 61108-2045 Ph: (224) 704-0909 |
| NPI Number | 1558122887 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 6204274061 |
|---|---|
| Medicare Enrollment ID | O20240329002046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558122887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Cristina Gloria |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245781566 PECOS PAC ID: 0749628501 Enrollment ID: I20240329002121 |
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