| Adventures Within Llc | |
|
315 E River Rd Ste 205 Brainerd MN 56401-3515 | |
| (218) 270-9525 | |
| (218) 524-3445 |
| Full Name | Adventures Within Llc |
|---|---|
| Speciality | Social Worker |
| Location | 315 E River Rd Ste 205, Brainerd, Minnesota |
| Authorized Official Name and Position | Jamie T Whiteman (OWNER) |
| Authorized Official Contact | 2182513647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventures Within Llc 16248 Birchwood Ln Brainerd MN 56401-6183 Ph: (218) 251-3647 | Adventures Within Llc 315 E River Rd Ste 205 Brainerd MN 56401-3515 Ph: (218) 270-9525 |
| NPI Number | 1932912300 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Medicare PECOS PAC ID | 5597295980 |
|---|---|
| Medicare Enrollment ID | O20250214001195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932912300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jamie Whiteman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194105205 PECOS PAC ID: 5395090435 Enrollment ID: I20180614000050 |
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