Healthcare Provider Details

I. General information

NPI: 1730097635
Provider Name (Legal Business Name): WELL INTO LIFE HOLISTIC CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CABARRUS AVE E STE 215
CONCORD NC
28025-4785
US

IV. Provider business mailing address

10 CABARRUS AVE E STE 215
CONCORD NC
28025-4785
US

V. Phone/Fax

Practice location:
  • Phone: 980-477-6637
  • Fax:
Mailing address:
  • Phone: 980-477-6637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EBONY S ROOKS
Title or Position: CLINICAL DIRECTOR
Credential: DNP, APRN, FNP-BC
Phone: 980-477-6637