| Clearwater Wellness Llc | |
|
8719 Battle Rd Ethel LA 70730-4007 | |
| (225) 205-9473 | |
| Not Available |
| Full Name | Clearwater Wellness Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8719 Battle Rd, Ethel, Louisiana |
| Authorized Official Name and Position | Alisa Johnson Willoughby (CEO) |
| Authorized Official Contact | 2252059473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clearwater Wellness Llc 8719 Battle Rd Ethel LA 70730-4007 Ph: (225) 205-9473 | Clearwater Wellness Llc 8719 Battle Rd Ethel LA 70730-4007 Ph: (225) 205-9473 |
| NPI Number | 1962256578 |
|---|---|
| Provider Enumeration Date | 04/11/2024 |
| Last Update Date | 04/11/2024 |
| Certification Date | 04/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962256578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |