Provider Demographics
NPI:1669159356
Name:JUST JOURNEY WELLNESS CLINIC LLC
Entity type:Organization
Organization Name:JUST JOURNEY WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APP
Authorized Official - Prefix:DR
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-BC
Authorized Official - Phone:309-281-9599
Mailing Address - Street 1:8295 TOURNAMENT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8900
Mailing Address - Country:US
Mailing Address - Phone:901-979-8565
Mailing Address - Fax:
Practice Address - Street 1:8295 TOURNAMENT DR STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8900
Practice Address - Country:US
Practice Address - Phone:901-979-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty