Provider Demographics
NPI:1457468936
Name:WL HEALTHSYSTEMS, INC
Entity Type:Organization
Organization Name:WL HEALTHSYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA-REVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-947-2005
Mailing Address - Street 1:13016 EASTFIELD RD STE 200-359
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6622
Mailing Address - Country:US
Mailing Address - Phone:704-947-2005
Mailing Address - Fax:704-947-2156
Practice Address - Street 1:5817 PROSPERITY CHURCH RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1128
Practice Address - Country:US
Practice Address - Phone:704-947-2005
Practice Address - Fax:704-947-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty