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Organization

IWILL TIL IMWELL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JILLANDRA ROVARIS PHD (CEO)
(504) 874-5809
Entity
Organization

Contact information

Practice address
1252 CLAYBURN LN, SAN JOSE, CA 95121-2610
(504) 874-5809
Mailing address
1252 CLAYBURN LN, SAN JOSE, CA 95121-2610
(504) 874-5809

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
09/30/2022
Last updated
10/25/2022
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