| Wind & Waves, Llc | |
|
1750 Kilbourn St Elkhart IN 46514-1920 | |
| (574) 327-6633 | |
| Not Available |
| Full Name | Wind & Waves, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1750 Kilbourn St, Elkhart, Indiana |
| Authorized Official Name and Position | Lesley D Weiss (CLINICIAN/THERAPIST) |
| Authorized Official Contact | 5743276633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wind & Waves, Llc 1750 Kilbourn St Elkhart IN 46514-1920 Ph: (574) 327-6633 | Wind & Waves, Llc 1750 Kilbourn St Elkhart IN 46514-1920 Ph: (574) 327-6633 |
| NPI Number | 1497227417 |
|---|---|
| Provider Enumeration Date | 01/02/2019 |
| Last Update Date | 01/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497227417 | NPI | - | NPPES |
| 1811167463 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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