Organization
EPIPHANY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYANA MOORE (CEO)
(980) 219-3318
Entity
Organization
Contact information
Practice address
1935 J N PEASE PL STE 201, CHARLOTTE, NC 28262-4542
(980) 219-3318
Mailing address
1935 J N PEASE PL STE 201, CHARLOTTE, NC 28262-4542
(980) 219-3318
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
10/06/2021
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