Organization
PREMCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI STONE (CO OWNER)
(980) 613-5304
Entity
Organization
Contact information
Practice address
1931 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4540
(980) 613-5304
Mailing address
8116 PIKE RD APT 1423, CHARLOTTE, NC 28262-3866
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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