Organization
LITTLE LIGHT MINISTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TUWAN MARCUS USSERY (DIRECTOR)
(704) 839-3767
Entity
Organization
Contact information
Practice address
3117 OLD HOUSE CIR, CIRCLE, MATTHEWS, NC 28105-7284
(704) 839-3767
Mailing address
PO BOX 480426, CHARLOTTE, NC 28269-5320
(704) 839-3767
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
060848
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603914
—
NC
Enumeration date
10/03/2006
Last updated
08/22/2020
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