Provider Demographics
NPI:1619291093
Name:JADE WELLNESS CENTER
Entity Type:Organization
Organization Name:JADE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRIGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-889-9000
Mailing Address - Street 1:4105 MONROEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2607
Mailing Address - Country:US
Mailing Address - Phone:412-380-0100
Mailing Address - Fax:
Practice Address - Street 1:4105 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2607
Practice Address - Country:US
Practice Address - Phone:412-380-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder