| Wellspring Family & Community Institute, Llc | |
|
23622 Rustic Oak Ct Spring TX 77373-7982 | |
| (832) 881-1264 | |
| (888) 467-1878 |
| Full Name | Wellspring Family & Community Institute, Llc |
|---|---|
| Speciality | Counselor |
| Location | 23622 Rustic Oak Ct, Spring, Texas |
| Authorized Official Name and Position | David L. Jones (MEMBER) |
| Authorized Official Contact | 8328811264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Family & Community Institute, Llc 23622 Rustic Oak Ct Spring TX 77373-7982 Ph: (832) 881-1264 | Wellspring Family & Community Institute, Llc 23622 Rustic Oak Ct Spring TX 77373-7982 Ph: (832) 881-1264 |
| NPI Number | 1902243256 |
|---|---|
| Provider Enumeration Date | 05/28/2013 |
| Last Update Date | 05/28/2013 |
| Medicare PECOS PAC ID | 5991948895 |
|---|---|
| Medicare Enrollment ID | O20160617001037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902243256 | NPI | - | NPPES |
| Provider Name | Eboni T Butler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972733723 PECOS PAC ID: 7618148479 Enrollment ID: I20110927000825 |
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