WELLPOINT RECOVERY LLC (NPI# 1518447309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518447309 |
| Entity Type | Organization |
| Organization Name | WELLPOINT RECOVERY LLC |
| Practice Address |
3930 Mezzanine Dr Ste B Lafayette IN 47905-8646 |
| Practice Telephone | 7657717108 |
| Practice Fax Number | 7652699569 |
| Mailing Telephone | 7657717108 |
| Mailing Fax Number | 7652699569 |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2019-03-11 |
| Authorized Official Name | AMABEL PIRIS (PRACTICE MANAGER) |
| Authorized Official Telephone | 7657717108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
3930 MEZZANINE DR STE B |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-8646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1750941902 | Unity Healthcare LLC | Clinic/Center | 1345 Unity Pl Ste 220, Lafayette, IN 47905-5761 | 2019-06-19 |
| 1942659354 | Michele Mclaverty | Clinic/Center | 379 Castello Rd, Lafayette, CA 94549-5606 | 2016-06-07 |
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| 1427425883 | Anu Gupta Desai, M.d., LLC | Clinic/Center | 155 Hospital Dr., Ste 300, Lafayette, LA 70503 | 2015-09-01 |
| 1346633831 | Minute Med Clinic - Pont De Mouton LLC | Clinic/Center | 104 Banister Court, Suite 1c, Lafayette, LA 70507 | 2015-03-09 |
| 1982045035 | Lafayette Family Healthcare Inc | Clinic/Center | 2008 Eraste Landry Rd, Suite B, Lafayette, LA 70506-1913 | 2013-07-17 |
| 1467710608 | Pediakare De Lousiana | Clinic/Center | 900 Walker Rd, Lafayette, LA 70506-1371 | 2012-04-25 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.