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Organization
ADDICTION WELLNESS CENTER IN LLC
Active
Organization
ADDICTION WELLNESS CENTER IN LLC
Active
Parent organization
ADDICTION WELLNESS CENTER IN LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADDICTION WELLNESS CENTER IN LLC
Authorized official
JESSIE COSTLEY (CREDENTIALING MANAGER)
(443) 452-3149
Entity
Organization
Contact information
Practice address
202 E MAPLE ST, JEFFERSONVILLE, IN 47130-3420
(812) 850-0619
(317) 458-1794
Mailing address
1100 BUSINESS PKWY S STE 1, WESTMINSTER, MD 21157-3048
(812) 850-0619
(317) 458-1794
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NULL
363A00000X
Physician Assistant
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/24/2026
Last updated
08/24/2026
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