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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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