Provider Demographics
NPI:1346651304
Name:BALD HEAD ISLAND CENTER FOR WELLNESS
Entity Type:Organization
Organization Name:BALD HEAD ISLAND CENTER FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:919-812-3935
Mailing Address - Street 1:PO BOX 1298
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 KEELSON ROW
Practice Address - Street 2:
Practice Address - City:BALD HEAD ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28461-5060
Practice Address - Country:US
Practice Address - Phone:919-812-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001631133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty