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Organization
WOLF CREEK WELLNESS LLC
Active
Organization
WOLF CREEK WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MAROON (CLINICAL DIRECTOR)
(330) 690-2337
Entity
Organization
Contact information
Practice address
680 HIGH ST STE A, WADSWORTH, OH 44281-1690
(306) 902-3373
(330) 822-6955
Mailing address
680 HIGH ST STE A, WADSWORTH, OH 44281-1690
(330) 690-2337
(330) 822-6955
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
34.009421
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251028
—
OH
01
—
E.0007875
LICENSE
OH
Enumeration date
02/23/2017
Last updated
03/06/2023
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