Provider Demographics
NPI:1841090941
Name:SOS WELLNESS LLC
Entity type:Organization
Organization Name:SOS WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-523-9966
Mailing Address - Street 1:6730 ROOSEVELT AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5736
Mailing Address - Country:US
Mailing Address - Phone:440-523-9966
Mailing Address - Fax:513-318-7388
Practice Address - Street 1:6730 ROOSEVELT AVE STE 301
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5736
Practice Address - Country:US
Practice Address - Phone:440-523-9966
Practice Address - Fax:513-318-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder