| Thrive4wholeness Llc | |
|
33 Murray Guard Dr Jackson TN 38305-3610 | |
| (731) 410-7719 | |
| (731) 214-1816 |
| Full Name | Thrive4wholeness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 33 Murray Guard Dr, Jackson, Tennessee |
| Authorized Official Name and Position | Elizabeth Wilson (OWNER/OPERATOR) |
| Authorized Official Contact | 7314107719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive4wholeness Llc 33 Murray Guard Dr Jackson TN 38305-3610 Ph: (731) 410-7719 | Thrive4wholeness Llc 33 Murray Guard Dr Jackson TN 38305-3610 Ph: (731) 410-7719 |
| NPI Number | 1346927050 |
|---|---|
| Provider Enumeration Date | 07/04/2023 |
| Last Update Date | 07/04/2023 |
| Certification Date | 07/03/2023 |
| Medicare PECOS PAC ID | 0749634426 |
|---|---|
| Medicare Enrollment ID | O20230928003154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346927050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth E Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437799012 PECOS PAC ID: 7810326550 Enrollment ID: I20200401002223 |
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