Organization
STRUCTURE THERAPEUTIC SERVICES
Active
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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