Organization
SUPPORTIVE HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATEEF COOK (PRESIDENT/CEO)
(929) 255-7761
Entity
Organization
Contact information
Practice address
3702 LARKHAVEN VILLAGE, CHARLOTTE, NC 28215
(929) 255-7761
Mailing address
3702 LARKHAVEN VILLAGE, CHARLOTTE, NC 28215
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/03/2021
Last updated
10/03/2021
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