Provider Demographics
NPI:1164835013
Name:COMMUNITY HEALTH &WELLNESS INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH &WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-247-5319
Mailing Address - Street 1:PO BOX 1403
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-1403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 N 13TH ST
Practice Address - Street 2:SUITE 18A
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-1700
Practice Address - Country:US
Practice Address - Phone:910-230-0626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health