1639958234 NPI number — BETTER DAYS MENTAL HEALTH & WELLNESS LLC

Table of content: (NPI 1639958234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639958234 NPI number — BETTER DAYS MENTAL HEALTH & WELLNESS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETTER DAYS MENTAL HEALTH & WELLNESS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639958234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6843 TOWNSHIP ROAD 1008 SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORNING
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43730-9765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-621-3840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6843 TOWNSHIP ROAD 1008 SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORNING
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-621-6268
Provider Business Practice Location Address Fax Number:
949-695-3758
Provider Enumeration Date:
09/25/2023

Additional Information

Authorized Official

Authorized Official Last Name:
DUNKLE
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
740-621-6268

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0044717 . This is a "MEDICAID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: MD8340779 . This is a "DEA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: H0002343 . This is a "MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0031991 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2023021334 . This is a "ANCC CERTIFICATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: APRN.CNP.0034050 . This is a "OHIO BOARD OF NURSING" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: RN.365428 . This is a "BOARD OF NURSING" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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