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General NPI Number Information
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NPI Number | 1760955736
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Entity Type | Organization
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Legal Business Name | GERIATRIC CONNECTIONS LLC
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 7085 TERRITORIAL RD
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City | BENTON HARBOR
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State | MI
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Zip | 49022-9458
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Country | US
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Telephone | 269-240-8042
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Fax |
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Provider Business Mailing Address
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Address Line | 7085 TERRITORIAL RD
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City | BENTON HARBOR
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State | MI
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Zip | 49022-9458
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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 | OWNER
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Name | JULIE WECKEL
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Credential |
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Telephone | 269-240-8042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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