| Joshua Tree Wellness Center Llc | |
|
726 Commercial St Ste B Emporia KS 66801-2906 | |
| (620) 344-2149 | |
| Not Available |
| Full Name | Joshua Tree Wellness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 726 Commercial St Ste B, Emporia, Kansas |
| Authorized Official Name and Position | Jayme Gillund (OWNER/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6203442149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Tree Wellness Center Llc 726 Commercial St Ste B Emporia KS 66801-2906 Ph: (620) 344-2149 | Joshua Tree Wellness Center Llc 726 Commercial St Ste B Emporia KS 66801-2906 Ph: (620) 344-2149 |
| NPI Number | 1992486427 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Certification Date | 07/27/2023 |
| Medicare PECOS PAC ID | 4981144144 |
|---|---|
| Medicare Enrollment ID | O20240913003378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992486427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Jayme E Gillund |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649315482 PECOS PAC ID: 5890235055 Enrollment ID: I20240917002090 |
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