| W.p.r. Llc | |
|
2733 Country Club Blvd Apt 87 Stockton CA 95204-3975 | |
| (209) 276-8892 | |
| Not Available |
| Full Name | W.p.r. Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2733 Country Club Blvd Apt 87, Stockton, California |
| Authorized Official Name and Position | Andrew Johnson (PRESIDENT) |
| Authorized Official Contact | 2092768892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| W.p.r. Llc 9919 Marquand Dr Burke VA 22015-3808 Ph: (206) 201-9454 | W.p.r. Llc 2733 Country Club Blvd Apt 87 Stockton CA 95204-3975 Ph: (209) 276-8892 |
| NPI Number | 1760965081 |
|---|---|
| Provider Enumeration Date | 09/12/2018 |
| Last Update Date | 09/26/2020 |
| Certification Date | 09/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760965081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 311Z00000X | Custodial Care Facility | (* (Not Available)) | Secondary |
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