Organization
PROFESSIONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERI T ELLISON (EXECUTIVE DIRECTOR/MEMBER)
(704) 484-1058
Entity
Organization
Contact information
Practice address
320 E GRAHAM ST, STE 1, SHELBY, NC 28150-5568
(704) 484-1058
(704) 484-0787
Mailing address
320 E GRAHAM ST, STE 1, SHELBY, NC 28150-5568
(704) 484-1058
(704) 484-0787
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302573
—
NC
Enumeration date
06/11/2010
Last updated
06/11/2010
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