Provider Demographics
NPI:1720117930
Name:WELLNESS SOLUTIONS CENTER, LLC
Entity Type:Organization
Organization Name:WELLNESS SOLUTIONS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-599-5361
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-0761
Mailing Address - Country:US
Mailing Address - Phone:919-599-5361
Mailing Address - Fax:919-530-5220
Practice Address - Street 1:1415 HOLLOWAY ST
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2125
Practice Address - Country:US
Practice Address - Phone:919-599-5361
Practice Address - Fax:919-530-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health