| Revolution Wellness Center Llc | |
|
17535 Rosbough Blvd Ste 202 Middleburg Heights OH 44130-8362 | |
| (216) 772-3310 | |
| (216) 251-8502 |
| Full Name | Revolution Wellness Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 17535 Rosbough Blvd Ste 202, Middleburg Heights, Ohio |
| Authorized Official Name and Position | Jennifer Adrienne Davis (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 2167723310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Wellness Center Llc 17535 Rosbough Blvd Ste 202 Middleburg Heights OH 44130-8362 Ph: (216) 772-3310 | Revolution Wellness Center Llc 17535 Rosbough Blvd Ste 202 Middleburg Heights OH 44130-8362 Ph: (216) 772-3310 |
| NPI Number | 1013611490 |
|---|---|
| Provider Enumeration Date | 03/29/2023 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013611490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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