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Organization
ONE LOVE PERIODIC SERVICES INC
Active
Organization
ONE LOVE PERIODIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVIE WIDEMAN (OWNER)
(704) 640-5501
Entity
Organization
Contact information
Practice address
100 QUEEN ST, MORGANTON, NC 28655-3440
(828) 433-4567
Mailing address
100 QUEEN ST, MORGANTON, NC 28655-3440
(828) 433-4567
(828) 433-4576
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207R00000X
Internal Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
291U00000X
Clinical Medical Laboratory
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301457
—
NC
05
—
8301744
—
NC
Enumeration date
01/09/2007
Last updated
09/28/2021
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