NPIMap

Organization Active NPI

Community Wellness & Support, LLC

  • Substance Abuse Rehabilitation Facility
  • Petersburg, VA
National Provider Identifier
1740766161
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
COMMUNITY WELLNESS & SUPPORT, LLC
Practice address
34 Medical Park Blvd Ste a
Petersburg, VA 23805-9283
Phone
(804) 909-2891
Fax
(804) 441-9089
NPI assigned
Jul 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Authorized official

Name
Mr. Clarence Harris
Title
Director of Services
Phone
(804) 909-2891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

34 Medical Park Blvd Ste a
Petersburg, VA 23805-9283

Mailing address

34 Medical Park Blvd Ste a
Petersburg, VA 23805-9283

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1740766161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MEDICAL PARK BLVD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "fax_number": "804-441-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MEDICAL PARK BLVD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "telephone_number": "804-909-2891",
            "fax_number": "804-441-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY WELLNESS & SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES",
        "authorized_official_telephone_number": "804-909-2891",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.