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NPI Code Detail

MEDICARE: TOTAL WELLNESS & DEVELOPMENT CENTER, INC

MEDICARE: TOTAL WELLNESS & DEVELOPMENT CENTER, INC
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
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821388851
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL WELLNESS & DEVELOPMENT CENTER, INC
Provider Business Mailing Address
First Line : 806 STAMPER RD STE 201
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28303-4100
Country : US
Telephone Number : 910-488-2894
Fax Number : 910-488-3861
Provider Business Practice Location Address
First Line : 806 STAMPER RD STE 201
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28303-4100
Country : US
Telephone Number : 910-488-2894
Fax Number : 910-488-3861
Authorized Official
Title or Position : PRESIDENT
Name : MRS. DONNA CARROLL
Credential :
Telephone Number : 910-488-2894
Provider Enumeration Date : 04/11/2011
Last Update Date : 04/19/2011

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