Provider Demographics
NPI:1508630476
Name:NC WELLNESS & RECOVERY
Entity Type:Organization
Organization Name:NC WELLNESS & RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSYTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-464-4283
Mailing Address - Street 1:4006 PEACHTREE TOWN LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7948
Mailing Address - Country:US
Mailing Address - Phone:919-464-4283
Mailing Address - Fax:919-420-3277
Practice Address - Street 1:4006 PEACHTREE TOWN LN
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7948
Practice Address - Country:US
Practice Address - Phone:919-464-4283
Practice Address - Fax:919-420-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health