| Eden Wellness Center Corporation Llc | |
|
6975 Sw Sandburg St Tigard OR 97223-8073 | |
| (480) 938-6189 | |
| Not Available |
| Full Name | Eden Wellness Center Corporation Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6975 Sw Sandburg St, Tigard, Oregon |
| Authorized Official Name and Position | Ntare Serge Sandrali (PARTNER) |
| Authorized Official Contact | 4809386189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Wellness Center Corporation Llc 6975 Sw Sandburg St Tigard OR 97223-8073 Ph: () - | Eden Wellness Center Corporation Llc 6975 Sw Sandburg St Tigard OR 97223-8073 Ph: (480) 938-6189 |
| NPI Number | 1487430971 |
|---|---|
| Provider Enumeration Date | 08/31/2023 |
| Last Update Date | 08/31/2023 |
| Certification Date | 08/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487430971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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