| Into The Wild, Inc. | |
|
5765 Shallowford Rd Lewisville NC 27023-9610 | |
| (336) 314-0051 | |
| Not Available |
| Full Name | Into The Wild, Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5765 Shallowford Rd, Lewisville, North Carolina |
| Authorized Official Name and Position | Max Goelling (CFO) |
| Authorized Official Contact | 3363140051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Into The Wild, Inc. Po Box 1291 King NC 27021-1291 Ph: (336) 314-0051 | Into The Wild, Inc. 5765 Shallowford Rd Lewisville NC 27023-9610 Ph: (336) 314-0051 |
| NPI Number | 1023775541 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023775541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Lewisville Family Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6620 Shallowford Rd, Suite 200, Lewisville, NC 27023 Phone: 336-757-0258 Fax: 336-945-0342 | |