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Organization
WELLNESS SUPPORTS, LLC
Active
Organization
WELLNESS SUPPORTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENDY LYNN WENZEL MSW (PRESIDENT)
(919) 782-8730
Entity
Organization
Contact information
Practice address
8390 SIX FORKS RD, SUITE 201, RALEIGH, NC 27615-3060
(919) 782-8730
(919) 782-8731
Mailing address
8390 SIX FORKS RD, SUITE 201, RALEIGH, NC 27615-3060
(919) 782-8730
(919) 782-8731
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6005366
NC
251S00000X
Community/Behavioral Health Agency
8300341B
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528138278
BLUE CROSS BLUE SHEILD
NC
05
—
6005366
—
NC
05
—
8300341B
—
NC
Enumeration date
11/09/2006
Last updated
10/07/2009
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