Healthcare Provider Details

I. General information

NPI: 1528998101
Provider Name (Legal Business Name): WONDERLANDD INTL COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3770 NAPIER AVE
MACON GA
31204-2753
US

IV. Provider business mailing address

3770 NAPIER AVE
MACON GA
31204-2753
US

V. Phone/Fax

Practice location:
  • Phone: 478-254-7171
  • Fax: 478-254-9736
Mailing address:
  • Phone: 478-254-7171
  • Fax: 478-254-9736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA F DUNCAN
Title or Position: OWNER
Credential: RN
Phone: 478-718-7331