Provider Demographics
NPI:1750749255
Name:COMPREHENSIVE WELLNESS CENTER
Entity type:Organization
Organization Name:COMPREHENSIVE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR, LPC
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRACZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MAED
Authorized Official - Phone:334-470-9395
Mailing Address - Street 1:16 TWIN OAKS PL
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-5100
Mailing Address - Country:US
Mailing Address - Phone:334-470-9395
Mailing Address - Fax:
Practice Address - Street 1:16 TWIN OAKS PL
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31407-5100
Practice Address - Country:US
Practice Address - Phone:334-470-9395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7862251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health