Basic Information
| Provider Information | |||||||||
| NPI: | 1215644620 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WAYPOINT WELLNESS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 WHITESBURG DR SW STE 30-141 | ||||||||
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| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358021698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565139232 | ||||||||
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| Practice Location | |||||||||
| Address1: | 212 BOB WALLACE AVE SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358013809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568082522 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2022 | ||||||||
| LastUpdateDate: | 11/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | NIEMANN | ||||||||
| AuthorizedOfficialFirstName: | LAYLA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/OPERATOR | ||||||||
| AuthorizedOfficialTelephone: | 2565139232 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LICSW | ||||||||
| NPICertificationDate: | 11/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.