MEDICARE: XOLANI CENTERS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	1041C0700X	Clinical Social Worker
5	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1396101200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XOLANI CENTERS, PLLC

Provider Business Mailing Address
First Line	:	7200 FALLS OF NEUSE RD STE 300
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-5384
Country	:	US
Telephone Number	:	919-210-7390
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 FALLS OF NEUSE RD
Second Line	:	SUITE 300
City	:	RALEIGH
State	:	NC
Zip	:	27615-5384
Country	:	US
Telephone Number	:	919-210-7390
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OUTPATIENT OPERATIONS
Name	:	AUTUMN KAYLEN MIZE
Credential	:
Telephone Number	:	984-200-2780

Provider Enumeration Date	:	01/07/2016
Last Update Date	:	02/05/2026

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