| Waves Of Hope, Llc | |
|
80 Smiley Rd Glen Campbell PA 15742-8611 | |
| (814) 935-9019 | |
| Not Available |
| Full Name | Waves Of Hope, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 80 Smiley Rd, Glen Campbell, Pennsylvania |
| Authorized Official Name and Position | Gina Wilson (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8149359019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waves Of Hope, Llc 80 Smiley Rd Glen Campbell PA 15742-8611 Ph: (814) 935-9019 | Waves Of Hope, Llc 80 Smiley Rd Glen Campbell PA 15742-8611 Ph: (814) 935-9019 |
| NPI Number | 1346936127 |
|---|---|
| Provider Enumeration Date | 04/13/2023 |
| Last Update Date | 04/13/2023 |
| Certification Date | 04/13/2023 |
| Medicare PECOS PAC ID | 1951742196 |
|---|---|
| Medicare Enrollment ID | O20240518000060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346936127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gina Marie Hetrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982320719 PECOS PAC ID: 2860833001 Enrollment ID: I20240518000087 |
Waves Of Hope, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 Smiley Rd, Glen Campbell, PA 15742 Phone: 814-935-9019 |