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General NPI Number Information
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NPI Number | 1265134001
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Entity Type | Organization
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Legal Business Name | LEARNWELL BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 2A MAIN STREET
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City | PLYMOUTH
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State | MA
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Zip | 02360
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Country | US
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Telephone | 508-562-2477
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Fax |
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Provider Business Mailing Address
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Address Line | 2A MAIN STREET
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City | PLYMOUTH
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State | MA
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Zip | 02360
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATHLEEN EGGER
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Credential | EDD
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Telephone | 508-562-2477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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