Lakeside Wellness Center

LBN: Wilmington Health Access For Teens, Inc
Lakeside Wellness Center is an health care organization with primary practice located at 4005 Oleander Dr , Wilmington NC 28403-6816. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Wilmington Health Access For Teens, Inc can be contacted via phone (910) 772-5552, or through Van De Bovenkamp, Maria via phone (910) 790-9949.

Contact Information

Primary practice address
4005 Oleander Dr Wilmington NC 28403-6816
Phone: (910) 772-5552
Fax: (910) 772-5554
Website:
Map and Directions
Authorized official contact:
Name: Van De Bovenkamp, Maria CMA (AAMA)
Phone: (910) 790-9949

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207QA0000X

Profile Details

NPI number 1568561207
LBN Legal business name Wilmington Health Access For Teens, Inc
DBA Doing business as Lakeside Wellness Center
Authorized official Van De Bovenkamp, Maria CMA (AAMA)
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 21st, 2006
Last updated Oct 28th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568561207 NPPES
North Carolina MEDICAID 8701703

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