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Organization
FAIR CHANCE LLC
Active
Organization
FAIR CHANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIANJAE AYANA JOHNSON MSW (PRESIDENT OF COMPANY)
(980) 208-8678
Entity
Organization
Contact information
Practice address
909 BOLIVIA DR, GASTONIA, NC 28054-4310
(980) 208-8678
Mailing address
1415 CHELVESTON DR, CHARLOTTE, NC 28208-6911
(980) 208-8678
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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