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Organization
SUNPATH LLC
Active
Organization
SUNPATH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA WIRTH BA,QMHP (EXECUTIVE DIRECTOR)
(704) 597-0021
Entity
Organization
Contact information
Practice address
11145 METROMONT PKWY, CHARLOTTE, NC 28269-7510
(704) 597-0021
Mailing address
11145 METROMONT PKWY, CHARLOTTE, NC 28269-7510
(704) 597-0021
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-060-1121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300197
—
NC
05
—
8300197S
—
NC
Enumeration date
04/06/2012
Last updated
05/21/2012
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