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NPI Code Detail

MEDICARE: PALMS WELLNESS CENTER

MEDICARE: PALMS WELLNESS CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
31041C0700XClinical Social Worker
42084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1255564225
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALMS WELLNESS CENTER
Provider Business Mailing Address
First Line : 2424 COMMERCE RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7505
Country : US
Telephone Number : 910-238-4200
Fax Number :
Provider Business Practice Location Address
First Line : 2424 COMMERCE RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7505
Country : US
Telephone Number : 910-238-4200
Fax Number :
Authorized Official
Title or Position : OWNER
Name : VICTOR R BARNES
Credential : M.D.
Telephone Number : 910-238-4200
Provider Enumeration Date : 08/25/2009
Last Update Date : 08/31/2009

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Directions to “PALMS WELLNESS CENTER ” Practice Location

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