Addiction Wellness Center in LLC
Organization Active NPI Physician Assistant · Jeffersonville, IN
NPI 1740197136 · NPPES record last updated Aug 24, 2026
Key facts
- NPI
- 1740197136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- Legal business name
- ADDICTION WELLNESS CENTER IN LLC
- Practice address
- 202 E Maple St
Jeffersonville, IN 47130-3420 - Phone
- (812) 850-0619
- Fax
- (317) 458-1794
- NPI assigned
- Aug 24, 2026
- Organization subpart
- Yes
- Parent organization (as reported)
- ADDICTION WELLNESS CENTER IN LLC
Authorized official
- Name
- Jessie Costley
- Title
- Credentialing Manager
- Phone
- (443) 452-3149
Parent organization (reported in NPPES) 1
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
202 E Maple St
Jeffersonville, IN 47130-3420
Mailing address
1100 Business Pkwy S Ste 1
Westminster, MD 21157-3048
Phone (812) 850-0619
Other providers in Jeffersonville, IN
- Alyssa Acton
- Michelle Adams
- Amelia Adamson
- Adaptive Hospice, LLC
- Addiction Wellness Center in LLC
- Titilayo Adeniyan
- Yetunde Adeyinka-de'Leon
- Advanced Regional Surgery Center, LLC
- Aegis Group Practice LLC
- Anthony Aemmer II
All providers in Jeffersonville, IN · Physician Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.