Healthcare Provider Details

I. General information

NPI: 1861397135
Provider Name (Legal Business Name): HOPE AND LIFE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4027 TRYON PARK RD APT 122
CHARLOTTE NC
28262-3691
US

IV. Provider business mailing address

4027 TRYON PARK RD APT 122
CHARLOTTE NC
28262-3691
US

V. Phone/Fax

Practice location:
  • Phone: 919-949-0301
  • Fax:
Mailing address:
  • Phone: 919-949-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ANTOINE RASHAD YANCEY
Title or Position: OWNER
Credential:
Phone: 919-949-0301