Organization
CORNUCOPIA WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY GARRIS LCAS (DIRECTOR)
(919) 808-5540
Entity
Organization
Contact information
Practice address
115 E HARDEN ST, SUITE 105, GRAHAM, NC 27253-3001
(919) 808-5540
Mailing address
115 E HARDEN ST, SUITE 105, GRAHAM, NC 27253-3001
(919) 808-5540
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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