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Organization

STRUCTURE THERAPEUTIC SERVICES

Active
Other names
Structure Therapeutic Services
Organization subpart
No

Provider details

NPI number
Authorized official
DERRICK LINDSAY (CHIEF EXECUTIVE OFFICER)
(704) 891-0053
Entity
Organization

Contact information

Practice address
4723 MORTONHALL RD, CHARLOTTE, NC 28215-7806
(704) 891-0053
Mailing address
4723 MORTONHALL RD, CHARLOTTE, NC 28215-7806
(704) 891-0053
(704) 891-0053

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320700000X
Physical Disabilities Residential Treatment Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
08/13/2025
Last updated
08/13/2025
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