Organization
WELLNESS GROVE LLC
Active
Other names
Wellness Grove
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN SWIGER (CHIEF INFORMATION OFFICER)
(330) 915-2907
Entity
Organization
Contact information
Practice address
4522 FULTON DR NW, CANTON, OH 44718-2332
(330) 915-2907
(330) 915-2958
Mailing address
4522 FULTON DR NW, CANTON, OH 44718-2332
(330) 915-2907
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
221700000X
Art Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085951
—
OH
Enumeration date
07/11/2024
Last updated
01/20/2026
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