| Roots 45 | |
|
100 W 1st St Gaylord MI 49735-1355 | |
| (989) 350-3053 | |
| Not Available |
| Full Name | Roots 45 |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 W 1st St, Gaylord, Michigan |
| Authorized Official Name and Position | Jennifer Ellen Wummel (BH THERAPIST) |
| Authorized Official Contact | 9893503053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots 45 2704 Hickorywood Dr Gaylord MI 49735-6403 Ph: (989) 350-3053 | Roots 45 100 W 1st St Gaylord MI 49735-1355 Ph: (989) 350-3053 |
| NPI Number | 1235725516 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 12/21/2020 |
| Certification Date | 12/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235725516 | NPI | - | NPPES |
| 6801097139 | Other | MI | MASTER'S SOCIAL WORKER LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Alcona Citizens For Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 912 N Ohio Ave, Gaylord, MI 49735 Phone: 989-731-2648 | |
Northern Michigan Substance Abuse Services, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2136 W M 32, Gaylord, MI 49735 Phone: 989-732-1791 Fax: 989-732-7052 | |
Marne March Olli, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 W Main St, Ste B, Gaylord, MI 49735 Phone: 989-350-0183 | |
Lasting Peace Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 236 W Main St, Gaylord, MI 49735 Phone: 989-546-9416 | |
Spacious Awareness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9960 Lynn Lake Rd, Gaylord, MI 49735 Phone: 440-382-7179 | |
Alcona Citizens For Health, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 E 4th St, Gaylord, MI 49735 Phone: 989-731-0856 |