Organization
MYSUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BRIAN IRVINE JR. CPSS (CEO)
(252) 339-0864
Entity
Organization
Contact information
Practice address
1100 ELLIOTT RD, CHARLOTTE, NC 28216-1317
(252) 339-0864
Mailing address
4509 FAIR SPRINGS RD, CHARLOTTE, NC 28227-5941
(252) 339-0864
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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