# UNITED PRIMARY DIAGNOSTIC CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316400088
- **Authorized official:** ENASHA L JAMES (MEDICAL ADMINISTRATOR)
- **Authorized official phone:** (980) 237-4768

## Contact information

- **Practice address:** 2103 N GRAHAM ST STE B, CHARLOTTE, NC 28206-2548
- **Practice address phone:** (336) 370-9232
- **Practice address fax:** (336) 274-7200
- **Mailing address:** 2103 N GRAHAM ST STE B, CHARLOTTE, NC 28206-2548
- **Mailing address phone:** (336) 370-9232
- **Mailing address fax:** (336) 274-7200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | Yes |
| 363LC1500X | Community Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/10/2019
- **Last updated:** 12/17/2020