| Sozo Wellness Centers Of America Llc | |
|
100 Biddle Ave Ste 204 Newark DE 19702-3981 | |
| (678) 296-0842 | |
| (770) 671-1951 |
| Full Name | Sozo Wellness Centers Of America Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Biddle Ave Ste 204, Newark, Delaware |
| Authorized Official Name and Position | Ronald Tyree (PMHNP) |
| Authorized Official Contact | 6782960842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sozo Wellness Centers Of America Llc 2805 Peachtree Industrial Blvd Ste 213 Duluth GA 30097-8171 Ph: (678) 296-0842 | Sozo Wellness Centers Of America Llc 100 Biddle Ave Ste 204 Newark DE 19702-3981 Ph: (678) 296-0842 |
| NPI Number | 1386399285 |
|---|---|
| Provider Enumeration Date | 02/18/2022 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Medicare PECOS PAC ID | 6103210109 |
|---|---|
| Medicare Enrollment ID | O20220308000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386399285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ronald James Tyree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083389324 PECOS PAC ID: 3577968890 Enrollment ID: I20210825002264 |
| Provider Name | Shildia L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336867829 PECOS PAC ID: 1759752116 Enrollment ID: I20230809003078 |
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