Provider Demographics
NPI:1760105217
Name:WELLNESS AND RESILIENCE CENTER LLC
Entity Type:Organization
Organization Name:WELLNESS AND RESILIENCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:JARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-673-6988
Mailing Address - Street 1:51 BEST ST FL 3
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4906
Mailing Address - Country:US
Mailing Address - Phone:937-673-6988
Mailing Address - Fax:937-223-8638
Practice Address - Street 1:51 BEST ST FL 3
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4906
Practice Address - Country:US
Practice Address - Phone:937-673-6988
Practice Address - Fax:937-223-8638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder