Organization
FIRST STEP DIRECT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN LAVERN GRAHAM II (ADMINISTRATIVE PROGRAM DIRECTOR)
(704) 395-2432
Entity
Organization
Contact information
Practice address
9726 BARK MEAD DR, CHARLOTTE, NC 28273-5400
(704) 395-2432
(704) 395-2432
Mailing address
PO BOX 668683, CHARLOTTE, NC 28266-8683
(704) 395-2432
(704) 395-2432
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL060-836
NC
Other
Enumeration date
02/07/2007
Last updated
08/22/2020
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