| Wings Support And Recovery | |
|
729 S Walnut St Marysville OH 43040-1643 | |
| (937) 642-9555 | |
| Not Available |
| Full Name | Wings Support And Recovery |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 729 S Walnut St, Marysville, Ohio |
| Authorized Official Name and Position | Jullian Griesheimer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9375999555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wings Support And Recovery 729 S Walnut St Marysville OH 43040-1643 Ph: (937) 642-9555 | Wings Support And Recovery 729 S Walnut St Marysville OH 43040-1643 Ph: (937) 642-9555 |
| NPI Number | 1669940995 |
|---|---|
| Provider Enumeration Date | 11/05/2018 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 5597109439 |
|---|---|
| Medicare Enrollment ID | O20240219001832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669940995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jullian Griesheimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982110029 PECOS PAC ID: 7214371152 Enrollment ID: I20240219002070 |
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