Provider Demographics
NPI:1679308274
Name:THE RIGHT SPIRIT WELLNESS CENTER LLC
Entity type:Organization
Organization Name:THE RIGHT SPIRIT WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:WEIGHTMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MS
Authorized Official - Phone:904-418-4019
Mailing Address - Street 1:5751 DICKSON RD FL 32211
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-4610
Mailing Address - Country:US
Mailing Address - Phone:904-418-4019
Mailing Address - Fax:
Practice Address - Street 1:804 3RD ST STE AB
Practice Address - Street 2:
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-5040
Practice Address - Country:US
Practice Address - Phone:904-513-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health