Organization
A SHOULDER TO LEAN ON IN NC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIA FUNDERBURK (ADMINISTRATOR)
(704) 488-3458
Entity
Organization
Contact information
Practice address
66 DENNIS ROAD, WADESBORO, NC 28170
(704) 507-1921
Mailing address
PO BOX 560575, CHARLOTTE, NC 28256-0575
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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