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Gordon Wellness Llc

Social Worker

Behavioral Health & Social Service Providers

610 Thimble Shoals Blvd # 403, Newport News, VA 23606-2573

PECOS Enrollment

Based on the most recent information from CMS, provider Gordon Wellness Llc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1376928101
Provider Type
Organization
Full Name
Gordon Wellness Llc

Subpart
No
Enumeration Date
7/22/2015
Last Updated
7/9/2024

Contact Information

Practice Location

610 Thimble Shoals Blvd # 403, Newport News, VA 23606-2573

(757) 534-7840

(757) 506-0432

Mailing Location

610 Thimble Shoals Blvd, 401-A, Newport News, VA 23606-2573

(757) 534-7840

(757) 534-7844

Authorized Official

Johnson, Tonya Dorline (Owner)

(757) 534-7840

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 090400826 Virginia

Gordon Wellness Llc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

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