Clevland Wellness Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

CLEVLAND WELLNESS CENTER

Practice address

1054 College Avenue
Shelby, NC 28080

Phone

(704) 853-0173

Fax

(704) 853-0535

NPI assigned

Aug 10, 2007

Last updated

Aug 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gwendolyn Diane Hughes

Title

Office Manager

Phone

(704) 853-0173

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1043402464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 LOCHSTONE DRIVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545186",
            "telephone_number": "704-853-0173",
            "fax_number": "704-853-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 COLLEGE AVENUE",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28080",
            "telephone_number": "704-853-0173",
            "fax_number": "704-853-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVLAND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-853-0173"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891036Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Shelby, NC
• Providers in Shelby, NC by specialty
• Substance Abuse Rehabilitation Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.