MEDICARE: PANDA RECOVERY SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	363LA2200X	Adult Health Nurse Practitioner
3	261QM0850X	Adult Mental Health Clinic/Center
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1417793639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANDA RECOVERY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5330 HEATHERDOWNS BLVD STE 208
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-4644
Country	:	US
Telephone Number	:	419-208-9121
Fax Number	:	419-208-9121

Provider Business Practice Location Address
First Line	:	5330 HEATHERDOWNS BLVD STE 208
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-4644
Country	:	US
Telephone Number	:	419-208-9121
Fax Number	:	419-208-9121

Authorized Official
Title or Position	:	PMHNP
Name	:	TAMESHIA WIGGINS
Credential	:
Telephone Number	:	419-208-9121

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

Similar Medicare Providers

1891263463 — TAMESHIA WIGGINS PMHNP-BC,AGNP-C
Practice Location Address:

5330 HEATHERDOWNS BLVD STE 207
TOLEDO, OH
43614-4644

Practice Phone: 419-314-9535
Practice Fax: 419-469-5495

1962553438 — MID-US MEDICAL INC.
Practice Location Address:

5330 HEATHERDOWNS BLVD STE 102
TOLEDO, OH
43614-4644

Practice Phone: 419-787-7506
Practice Fax:

1053965897 — MS. JULIE KAY DUNN LSW
Practice Location Address:

5330 HEATHERDOWNS BLVD STE 100
TOLEDO, OH
43614-4644

Practice Phone: 419-351-4206
Practice Fax: 419-861-3720

1457944696 — ROSE LOVING CARE
Practice Location Address:

5330 HEATHERDOWNS BLVD STE 102
TOLEDO, OH
43614-4644

Practice Phone: 419-378-2331
Practice Fax: 513-672-2165

1265142780 — EVOLVE WELLNESS & IV HYDRATION CENTER LLC
Practice Location Address:

5330 HEATHERDOWNS BLVD STE 207
TOLEDO, OH
43614-4644

Practice Phone: 419-314-9535
Practice Fax: 419-469-5495

1386311611 — AARION GROSS PHYSICIAN ASSISTANT
Practice Location Address:

3333 GLENDALE AVE
TOLEDO, OH
43614-2426

Practice Phone: 419-383-5555
Practice Fax:

Directions to “PANDA RECOVERY SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.