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TWO ROADS WELLNESS CLINIC LLC NPI 1417329426


NPI Information

NPI: 1417329426
Provider Name: TWO ROADS WELLNESS CLINIC, LLC

Doing Business As: TWO ROADS WELLNESS CLINIC

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 14D2187374

Address:
3545 N VERMILION ST
DANVILLE, IL
ZIP 61832
Phone: (217) 651-6801
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TWO ROADS WELLNESS CLINIC, LLC is a community behavioral health in Danville, IL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. TWO ROADS WELLNESS CLINIC, LLC NPI is 1417329426. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Two Roads Wellness Clinic.

The provider's business location address is:

3545 N VERMILION ST
DANVILLE, IL
ZIP 61832-100
Phone: (217) 651-6801
Fax: (217) 651-6802

The provider's authorized official is Jessica Nemecz .
The authorized official title is Counselor and has the following contact phone number (217) 651-6801.

The CLIA number assigned to this NPI record is 14D2187374 - other - aprns with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/29/2015 and was last updated on 2/28/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2261QP2000XClinic/CenterPhysical TherapyNo
3363L00000XNurse PractitionerNo
4251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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