Provider Demographics
NPI:1124712559
Name:NOBLE WELLNESS GROUP
Entity type:Organization
Organization Name:NOBLE WELLNESS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-914-5910
Mailing Address - Street 1:2228 PINCKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1852
Mailing Address - Country:US
Mailing Address - Phone:704-914-5910
Mailing Address - Fax:
Practice Address - Street 1:819 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2025
Practice Address - Country:US
Practice Address - Phone:704-914-5910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty