=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932055001
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GGSWELLNESS CENTERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2026
-----------------------------------------------------
Last Update Date | 03/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5207 OLD RURAL HALL RD
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27105-2336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-608-9447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4600 PETER PFAFF DR
-----------------------------------------------------
City | PFAFFTOWN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27040-9537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | REGINALD GILES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-608-9447
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 320800000X
-----------------------------------------------------
Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------