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General NPI Number Information
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NPI Number | 1003280025
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Entity Type | Organization
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Legal Business Name | AMARA WELLNESS
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 11/16/2015
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Provider Practice Location Address
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Address Line | 2025 MARNETT BOULEVARD
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City | ROCK HILL
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State | SC
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Zip | 29730
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Country | US
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Telephone | 704-567-0790
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Fax |
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Provider Business Mailing Address
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Address Line | 2025 MARNETTE BLVD ROCK HILL
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City | ROCK HILL
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State | SC
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Zip | 29732
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Country | US
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Telephone | 704-968-5019
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERICA CORBIN
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Credential |
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Telephone | 704-567-0790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 230843
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License Number State | SC
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