Healthcare Provider Details

I. General information

NPI: 1831052737
Provider Name (Legal Business Name): COMMUNITY WELLNESS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 WELLINGHAM AVE APT 63
GREENVILLE NC
27834-4642
US

IV. Provider business mailing address

157 WELLINGHAM AVE APT 63
GREENVILLE NC
27834-4642
US

V. Phone/Fax

Practice location:
  • Phone: 252-470-4941
  • Fax:
Mailing address:
  • Phone: 252-470-4941
  • Fax:

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: ALTON MONTREAL ROGERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-470-4941