Organization
CLASSIFIED GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WOLFE (PRESIDENT)
(786) 412-1514
Entity
Organization
Contact information
Practice address
520 LAKE HOLDING ST, WAKE FOREST, NC 27587-6856
(786) 412-1514
Mailing address
520 LAKE HOLDING ST, WAKE FOREST, NC 27587-6856
(786) 412-1514
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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