Organization
CHARLOTTE COMMUNITY HEALTH CLINIC, INC.
Active
Organization
CHARLOTTE COMMUNITY HEALTH CLINIC, INC.
Active
Other names
Smith Family Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANI PRISCILIA RUARTE (CREDENTIALING COORDINATOR)
(704) 316-6573
Entity
Organization
Contact information
Practice address
3622 CENTRAL AVE, CHARLOTTE, NC 28205-5638
(704) 316-6561
(704) 384-1977
Mailing address
8401 MEDICAL PLAZA DR STE 300, CHARLOTTE, NC 28262-8702
(704) 316-6561
(704) 384-1977
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
08/15/2022
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