Organization
WELLPOINT RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMABEL PIRIS (PRACTICE MANAGER)
(765) 771-7108
Entity
Organization
Contact information
Practice address
3930 MEZZANINE DR STE B, LAFAYETTE, IN 47905-8646
(765) 771-7108
(765) 269-9569
Mailing address
3930 MEZZANINE DR STE B, LAFAYETTE, IN 47905-8646
(765) 771-7108
(765) 269-9569
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/21/2018
Last updated
03/11/2019
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