# CAROLINA HEALTH AND WELLNESS SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043804388
- **Authorized official:** DR. BLAKE DOUGLAS DEVOLLD ED.D. (PRACTICE MANAGER)
- **Authorized official phone:** (843) 996-4908

## Contact information

- **Practice address:** 2754 MAYBANK HWY STE B, JOHNS ISLAND, SC 29455-4809
- **Practice address phone:** (843) 996-4908
- **Practice address fax:** (843) 962-5450
- **Mailing address:** 2754 MAYBANK HWY STE B, JOHNS ISLAND, SC 29455-4809
- **Mailing address phone:** (843) 996-4908
- **Mailing address fax:** (843) 962-5450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2021
- **Last updated:** 02/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 406340 | — | SC |