INNOVATIVE HEALTH & WELLNESS LLC 2 (NPI# 1598373870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598373870 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE HEALTH & WELLNESS LLC 2 |
| Practice Address |
2300 Humbug Creek Rd Jacksonville OR 97530-9617 |
| Practice Telephone | 7025227363 |
| Mailing Telephone | 7025227363 |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | CARLOS R POLLARD (CEO) |
| Authorized Official Telephone | 7023242126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172V00000X | Community Health Worker | Other Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
2300 HUMBUG CREEK RD |
| City | JACKSONVILLE |
| State | OR |
| Zip Code | 97530-9617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083112957 | Cody Moss | Chiropractor | 660 G St Ste A, Jacksonville, OR 97530 | 2018-01-25 |
| 1659819621 | Denise Alane Davis | Nurse Practitioner | 115 Ponderosa Way, Jacksonville, OR 97530 | 2017-02-09 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| 1023444502 | Rebecca Lynne Giudili | Behavioral Analyst | 1425 Humbug Ck Rd, Jacksonville, OR 97530 | 2013-09-17 |
| 1487922381 | Ashley Rose Merrill | Midwife | 235 E. Main St., Jacksonville, OR 97530 | 2011-12-06 |
| 1518135334 | Lynn Ellen Reordan | Physical Therapist | 635 N. 5th St., Jacksonville, OR 97530 | 2008-02-14 |
| 1821289984 | Nathan M Tanner | Dentist | 725 N 5th St Ste 101, Jacksonville, OR 97530 | 2007-08-05 |
| 1467667139 | Diana K Helvey | Denturist | 590 Blackstone Alley, Jacksonville, OR 97530 | 2007-05-14 |
| 1902027295 | Michelle Dawn Bienick | Naprapath | 1881 Humbug Creek Rd, Applegate, OR 97530 | 2007-05-02 |
| 1821121526 | Anne Marie Vincent | Chiropractor | 7370 Hwy 238, Jacksonville, OR 97530 | 2007-03-13 |
| Find all providers in zip 97530 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 97530 |
Please comment or provide details below to improve the information on INNOVATIVE HEALTH & WELLNESS LLC 2.
| 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.