Organization
CLEVLAND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN DIANE HUGHES (OFFICE MANAGER)
(704) 853-0173
Entity
Organization
Contact information
Practice address
1054 COLLEGE AVENUE, SHELBY, NC 28080
(704) 853-0173
(704) 853-0535
Mailing address
2488 LOCHSTONE DRIVE, GASTONIA, NC 28054-5186
(704) 853-0173
(704) 853-0535
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891036Y
—
NC
Enumeration date
08/10/2007
Last updated
08/10/2007
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