| Luna Wellness Llc | |
|
404 Hamilton Rd Ste 4 Wapakoneta OH 45895-1156 | |
| (419) 739-7002 | |
| Not Available |
| Full Name | Luna Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 404 Hamilton Rd Ste 4, Wapakoneta, Ohio |
| Authorized Official Name and Position | Gloria Marie Esquivel-lynch (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4197397002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luna Wellness Llc Po Box 62 Wapakoneta OH 45895-0062 Ph: () - | Luna Wellness Llc 404 Hamilton Rd Ste 4 Wapakoneta OH 45895-1156 Ph: (419) 739-7002 |
| NPI Number | 1518588441 |
|---|---|
| Provider Enumeration Date | 05/01/2020 |
| Last Update Date | 05/30/2021 |
| Certification Date | 05/30/2021 |
| Medicare PECOS PAC ID | 1456774074 |
|---|---|
| Medicare Enrollment ID | O20200714003542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518588441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gloria M Esquivel Lynch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922185206 PECOS PAC ID: 5092759845 Enrollment ID: I20200714003672 |
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