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Organization
ST. MICHAEL'S THERAPEUTIC SERVICES, INC
Active
Organization
ST. MICHAEL'S THERAPEUTIC SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TASHEEMA YVETTE SHORE BS.QP (OWNER)
(704) 701-2582
Entity
Organization
Contact information
Practice address
708 S ROWAN AVE, SPENCER, NC 28159-2146
(704) 637-3375
(704) 637-3375
Mailing address
708 S ROWAN AVE, SPENCER, NC 28159-2146
(704) 637-3375
(704) 637-3375
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-080-120
NC
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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