OrganizationWellness Supports, LlcCommunity/Behavioral HealthAgenciesPractice Address8390 Six Forks Rd, Suite 201, Raleigh, NC 27615-3060(919) 782-8730PECOS EnrollmentBased on the most recent information from CMS, provider Wellness Supports, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1528138278Provider TypeOrganizationFull NameWellness Supports, LlcSubpartNoEnumeration Date11/9/2006Last Updated10/7/2009Contact InformationPractice LocationPractice Address8390 Six Forks Rd, Suite 201, Raleigh, NC 27615-3060Phone(919) 782-8730Fax(919) 782-8731Mailing LocationMailing Address8390 Six Forks Rd, Suite 201, Raleigh, NC 27615-3060Phone(919) 782-8730Fax(919) 782-8731Authorized OfficialNameWenzel, Wendy Lynn (President)Phone(919) 782-8730Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicense6005366North CarolinaCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicense8300341BNorth CarolinaProvider IdentifiersIDDescriptionIssuerID6005366DescriptionMedicaidIssuerUnlistedNorth CarolinaID1528138278DescriptionOtherIssuerBLUE CROSS BLUE SHEILDNorth CarolinaID8300341BDescriptionMedicaidIssuerUnlistedNorth Carolina