Community Wellness Group LLC
Internal Medicine in Columbia, SC. Organization (NPI-2).
NPI number1982144606
StatusActive
Last updated in NPPESDec 7, 2021
Details
- NPI
- 1982144606
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Wellness Group LLC
- Organization subpart
- No
- Enumeration date
- Feb 28, 2017
- Certification date
- Dec 7, 2021
- Last updated
- Dec 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 101YP2500X | Counselor, Professional | – | – | |
| 103T00000X | Psychologist | – | – | |
| 111N00000X | Chiropractor | – | – | |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | |
| 2083A0300X | Preventive Medicine, Addiction Medicine | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – |
Practice location
2430 Atlas Rd Ste 1Columbia, SC 29209-3625
Phone 803-586-1752 · Fax 877-995-5934
Mailing address
7356 Garners Ferry Rd Suite 130Columbia, SC 29209-2178
Phone 803-586-1752 · Fax 877-995-5934
Authorized official
Kenneth Allan Simmons
Director/Manager
8035861752
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