| Rai Of Sonshine Wellness | |
|
235 Tyler St East Haven CT 06512-2954 | |
| (203) 393-6288 | |
| Not Available |
| Full Name | Rai Of Sonshine Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 235 Tyler St, East Haven, Connecticut |
| Authorized Official Name and Position | Sharelle Blatche (OWNER) |
| Authorized Official Contact | 2033936288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rai Of Sonshine Wellness 235 Tyler St East Haven CT 06512-2954 Ph: (203) 393-6288 | Rai Of Sonshine Wellness 235 Tyler St East Haven CT 06512-2954 Ph: (203) 393-6288 |
| NPI Number | 1033837406 |
|---|---|
| Provider Enumeration Date | 08/21/2022 |
| Last Update Date | 09/11/2022 |
| Certification Date | 09/11/2022 |
| Medicare PECOS PAC ID | 4284019068 |
|---|---|
| Medicare Enrollment ID | O20220914002339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033837406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sharelle Nikita Blatche |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790403111 PECOS PAC ID: 5193100972 Enrollment ID: I20220914002531 |
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