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NPI Code Detail

MEDICARE: WELLNESS AND RESILIENCE CENTER LLC

MEDICARE: WELLNESS AND RESILIENCE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1063135507
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLNESS AND RESILIENCE CENTER LLC
Provider Business Mailing Address
First Line : 51 BEST ST FL 3
Second Line :
City : DAYTON
State : OH
Zip : 45405-4906
Country : US
Telephone Number : 937-673-6988
Fax Number : 937-223-8638
Provider Business Practice Location Address
First Line : 51 BEST ST FL 3
Second Line :
City : DAYTON
State : OH
Zip : 45405-4906
Country : US
Telephone Number : 937-673-6988
Fax Number : 937-223-8638
Authorized Official
Title or Position : OWNER / EXECUTIVE DIRECTOR
Name : KIMBERLY D JARVIS
Credential :
Telephone Number : 937-673-6988
Provider Enumeration Date : 09/20/2022
Last Update Date : 09/20/2022

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Directions to “WELLNESS AND RESILIENCE CENTER LLC ” Practice Location

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