Healthcare Provider Details
I. General information
NPI: 1689217564
Provider Name (Legal Business Name): HAKUNA WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2019
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 S JIMMIES CREEK DR
NEW BERN NC
28562-3704
US
IV. Provider business mailing address
304 S JIMMIES CREEK DR
NEW BERN NC
28562-3704
US
V. Phone/Fax
- Phone: 252-631-6059
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
EKLUND
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 252-638-3888