| Stable Gains Mental Health Service Llc | |
|
304 N Walnut St Rm 9 Plymouth IN 46563-1787 | |
| (574) 701-2355 | |
| Not Available |
| Full Name | Stable Gains Mental Health Service Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 304 N Walnut St Rm 9, Plymouth, Indiana |
| Authorized Official Name and Position | Jodie Kay Gaines (MEMBER MANAGER) |
| Authorized Official Contact | 5747012355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stable Gains Mental Health Service Llc Po Box 404 Plymouth IN 46563-0404 Ph: (574) 701-2355 | Stable Gains Mental Health Service Llc 304 N Walnut St Rm 9 Plymouth IN 46563-1787 Ph: (574) 701-2355 |
| NPI Number | 1851196455 |
|---|---|
| Provider Enumeration Date | 02/17/2025 |
| Last Update Date | 02/17/2025 |
| Certification Date | 02/17/2025 |
| Medicare PECOS PAC ID | 8527589076 |
|---|---|
| Medicare Enrollment ID | O20250312003903 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851196455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jodie Kay Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669191490 PECOS PAC ID: 7618401977 Enrollment ID: I20241108000579 |
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