# KATRINA RENEES SAFE PLACE LLC

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

## Provider details

- **NPI number:** 1528812930
- **Authorized official:** MS. KATRINA R. BRYANT MS, LCAS (OWNER)
- **Authorized official phone:** (704) 352-8043

## Contact information

- **Practice address:** 5017 ELIZABETH RD, CHARLOTTE, NC 28269-4534
- **Practice address phone:** (704) 352-8043
- **Mailing address:** 1213 W MOREHEAD ST, CHARLOTTE, NC 28208-5576
- **Mailing address phone:** (704) 325-8336
- **Mailing address fax:** (704) 325-8356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/12/2024
- **Last updated:** 04/12/2024