| Aloha Psychiatric And Wellness, Llc | |
|
3625 E 20th St Ste B Joplin MO 64801-5981 | |
| (417) 861-1945 | |
| Not Available |
| Full Name | Aloha Psychiatric And Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3625 E 20th St Ste B, Joplin, Missouri |
| Authorized Official Name and Position | Amy Baremore (OWNER/PMHNP) |
| Authorized Official Contact | 4178611945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aloha Psychiatric And Wellness, Llc 4785 S Mary Ann Ave Springfield MO 65810-1089 Ph: (417) 861-1945 | Aloha Psychiatric And Wellness, Llc 3625 E 20th St Ste B Joplin MO 64801-5981 Ph: (417) 861-1945 |
| NPI Number | 1326814203 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 3476998204 |
|---|---|
| Medicare Enrollment ID | O20240301003217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326814203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amy Chrisandra Baremore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578193637 PECOS PAC ID: 0143643353 Enrollment ID: I20200707001539 |
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