Provider Demographics
NPI:1477312015
Name:ONWARD HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:ONWARD HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FILLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:801-824-1541
Mailing Address - Street 1:550 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97344-9704
Mailing Address - Country:US
Mailing Address - Phone:801-824-1541
Mailing Address - Fax:
Practice Address - Street 1:1900 HINES ST SE STE 190
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1356
Practice Address - Country:US
Practice Address - Phone:801-824-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty