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NPI Code Detail

MEDICARE: WELLMORE CENTRE LLC

MEDICARE: WELLMORE CENTRE 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669940870
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLMORE CENTRE LLC
Provider Business Mailing Address
First Line : 204 2ND ST NE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-2808
Country : US
Telephone Number : 234-801-2469
Fax Number : 330-364-9212
Provider Business Practice Location Address
First Line : 204 2ND ST NE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-2808
Country : US
Telephone Number : 234-801-2469
Fax Number : 330-364-9212
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. MARK ANDREW WELTY
Credential : PH.D.
Telephone Number : 234-801-2469
Provider Enumeration Date : 11/06/2018
Last Update Date : 10/01/2025

Similar Medicare Providers

1942320858 — DR. MARK ANDREW WELTY LPCC-S
Practice Location Address:
204 2ND ST NE
NEW PHILADELPHIA, OH
44663-2808
Practice Phone: 234-801-2469
Practice Fax: 330-364-9212
1376759670 — FAYE J OLSON RN
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204 2ND ST NE
NEW PHILADELPHIA, OH
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1699110056 — MR. GREGORY S WRIGHT PC-CR
Practice Location Address:
204 2ND ST NE
NEW PHILADELPHIA, OH
44663-2808
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1487150470 — WELLMORE CENTRE LLC
Practice Location Address:
204 2ND ST NE
NEW PHILADELPHIA, OH
44663-2808
Practice Phone: 234-801-2469
Practice Fax:
1265911267 — FAITH MARIE CLUM CDCA
Practice Location Address:
204 2ND ST NE
NEW PHILADELPHIA, OH
44663-2808
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1760963110 — MICHAEL WOLFARTH CDCA
Practice Location Address:
204 2ND ST NE
NEW PHILADELPHIA, OH
44663-2808
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Practice Fax:

Directions to “WELLMORE CENTRE LLC ” Practice Location

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