| Zion Healing Center Jacksonville | |
|
6 Blackstone Valley Pl Ste 301 Lincoln RI 02865-1112 | |
| (508) 769-2707 | |
| (401) 305-3028 |
| Full Name | Zion Healing Center Jacksonville |
|---|---|
| Speciality | General Practice |
| Location | 6 Blackstone Valley Pl Ste 301, Lincoln, Rhode Island |
| Authorized Official Name and Position | Boris O. Bergus (CEO) |
| Authorized Official Contact | 5087692707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zion Healing Center Jacksonville 6 Blackstone Valley Pl Ste 301 Lincoln RI 02865-1112 Ph: (508) 769-2707 | Zion Healing Center Jacksonville 6 Blackstone Valley Pl Ste 301 Lincoln RI 02865-1112 Ph: (508) 769-2707 |
| NPI Number | 1457302002 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 05/30/2023 |
| Certification Date | 05/30/2023 |
| Medicare PECOS PAC ID | 6002828589 |
|---|---|
| Medicare Enrollment ID | O20100302000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457302002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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