Organization
EMPOWERING SPACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEON CARROLL SMITH JR. (PRESIDENT)
(980) 266-2687
Entity
Organization
Contact information
Practice address
4927 REEDMONT LN, CHARLOTTE, NC 28269-1631
(980) 266-2687
Mailing address
4927 REEDMONT LN, CHARLOTTE, NC 28269-1631
(980) 266-2687
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/27/2023
Last updated
10/16/2023
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