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Organization
JWIGGINSBUSINESSINABOX
Active
Organization
JWIGGINSBUSINESSINABOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADA MAHOGANY WIGGINS (OWNER)
(413) 222-3267
Entity
Organization
Contact information
Practice address
2722 CATALINA AVE, CHARLOTTE, NC 28206-2237
(413) 222-3267
Mailing address
7917 SUTTONVIEW DR, CHARLOTTE, NC 28269-5236
(413) 222-3267
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
06/09/2022
Last updated
08/04/2022
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