NPIMap

Organization Active NPI

Wellness and Resilience Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
National Provider Identifier
1063135507
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WELLNESS AND RESILIENCE CENTER LLC
Practice address
51 Best St FL 3
Dayton, OH 45405-4906
Phone
(937) 673-6988
Fax
(937) 223-8638
NPI assigned
Sep 20, 2022
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly D JarvisNPI 1366170946
Title
Owner / Executive Director
Phone
(937) 673-6988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

51 Best St FL 3
Dayton, OH 45405-4906

Mailing address

51 Best St FL 3
Dayton, OH 45405-4906
Phone (937) 673-6988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230925002719 OH Part B Supplier - Clinic/Group Practice 6406200492 Receives reassigned benefits from 3 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory
Tax ID family
Wellness and Resilience Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1063135507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BEST ST FL 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054906",
            "telephone_number": "937-673-6988",
            "fax_number": "937-223-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BEST ST FL 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054906",
            "telephone_number": "937-673-6988",
            "fax_number": "937-223-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS AND RESILIENCE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER / EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-673-6988"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.