| Restoring You Wellness Center Llc | |
|
1113 S Main St Ste F Cheshire CT 06410-3436 | |
| (203) 699-6318 | |
| Not Available |
| Full Name | Restoring You Wellness Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1113 S Main St Ste F, Cheshire, Connecticut |
| Authorized Official Name and Position | Brittney Jackson (MEMBER) |
| Authorized Official Contact | 2036996318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoring You Wellness Center Llc 1113 S Main St Ste F Cheshire CT 06410-3436 Ph: (203) 699-6318 | Restoring You Wellness Center Llc 1113 S Main St Ste F Cheshire CT 06410-3436 Ph: (203) 699-6318 |
| NPI Number | 1023650090 |
|---|---|
| Provider Enumeration Date | 10/11/2019 |
| Last Update Date | 01/24/2022 |
| Certification Date | 01/24/2022 |
| Medicare PECOS PAC ID | 0749612935 |
|---|---|
| Medicare Enrollment ID | O20191108000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023650090 | NPI | - | NPPES |
| Provider Name | Brittney Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639728231 PECOS PAC ID: 1850622713 Enrollment ID: I20191008002946 |
| Provider Name | De'andrea Dillard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063845766 PECOS PAC ID: 3678905874 Enrollment ID: I20191108001228 |
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