| NPI | 1235785726 |
|---|---|
| Doing Business As | WELLNESS RENEWAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CHARLES KEVIN BLACKMON President 336-210-0893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |