Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Other names
NC MENTOR
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DAVIS (STATE DIRECTOR)
(919) 790-8580
Entity
Organization
Contact information
Practice address
542 WILLIAMSON RD, SUITE 6, MOORESVILLE, NC 28117-8193
(919) 790-8580
(919) 866-3255
Mailing address
3125 POPLARWOOD CT, SUITE 300, RALEIGH, NC 27604-1084
(919) 790-8580
(919) 866-3255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8303026
—
NC
Enumeration date
03/12/2007
Last updated
03/27/2009
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