| Watershed Wellness Collective Llc | |
|
412 Gallatin Pike S Madison TN 37115-4009 | |
| (310) 266-5044 | |
| Not Available |
| Full Name | Watershed Wellness Collective Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 412 Gallatin Pike S, Madison, Tennessee |
| Authorized Official Name and Position | Melisse Prusinski (OWNER/PROVIDER) |
| Authorized Official Contact | 3102665044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Watershed Wellness Collective Llc 1127 Tuckahoe Dr Nashville TN 37207-1640 Ph: (310) 266-5044 | Watershed Wellness Collective Llc 412 Gallatin Pike S Madison TN 37115-4009 Ph: (310) 266-5044 |
| NPI Number | 1033966940 |
|---|---|
| Provider Enumeration Date | 04/30/2024 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033966940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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