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Organization

FULFILLED SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINWOOD HIGH (OWNER/MANAGER)
(980) 428-4751
Entity
Organization

Contact information

Practice address
3148 MARGELLINA DR, CHARLOTTE, NC 28210-4001
(980) 428-4751
Mailing address
3148 MARGELLINA DR, CHARLOTTE, NC 28210-4001

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
08/03/2012
Last updated
08/03/2012
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