| Willow Grove Wellness, Llc | |
|
10315 S 275 E Flat Rock IN 47234-9730 | |
| (317) 426-1847 | |
| Not Available |
| Full Name | Willow Grove Wellness, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10315 S 275 E, Flat Rock, Indiana |
| Authorized Official Name and Position | Jessica V Jacobs (OWNER) |
| Authorized Official Contact | 3174261847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Grove Wellness, Llc 3129 25th St # 224 Columbus IN 47203-2436 Ph: (317) 426-1847 | Willow Grove Wellness, Llc 10315 S 275 E Flat Rock IN 47234-9730 Ph: (317) 426-1847 |
| NPI Number | 1104565605 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 06/02/2022 |
| Certification Date | 06/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104565605 | NPI | - | NPPES |
| 1255733689 | Medicaid | IN | |
| 1972071405 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |