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Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Other names
NC MENTOR
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DAVIS (STATE DIRECTOR)
(919) 790-8580
Entity
Organization
Contact information
Practice address
542 WILLIAMSON RD, SUITE 6, MOORESVILLE, NC 28117-8193
(919) 790-8580
(919) 866-3255
Mailing address
3125 POPLARWOOD CT, SUITE 300, RALEIGH, NC 27604-1084
(919) 790-8580
(919) 866-3255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8303026
—
NC
Enumeration date
03/12/2007
Last updated
03/27/2009
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