Willow Grove Wellness, Llc | |
10315 S 275 E Flat Rock IN 47234-9730 | |
(317) 426-1847 | |
Not Available |
Full Name | Willow Grove Wellness, Llc |
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Speciality | Social Worker - Clinical |
Location | 10315 S 275 E, Flat Rock, Indiana |
Authorized Official Name and Position | Jessica V Jacobs (OWNER) |
Authorized Official Contact | 3174261847 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Willow Grove Wellness, Llc 3129 25th St # 224 Columbus IN 47203-2436 Ph: (317) 426-1847 | Willow Grove Wellness, Llc 10315 S 275 E Flat Rock IN 47234-9730 Ph: (317) 426-1847 |
NPI Number | 1104565605 |
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Provider Enumeration Date | 06/02/2022 |
Last Update Date | 06/02/2022 |
Certification Date | 06/02/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104565605 | NPI | - | NPPES |
1255733689 | Medicaid | IN | |
1972071405 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |