Organization
DEDICATED 2 LIBERATING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DECORA BOWERS (OWNER)
(980) 318-3125
Entity
Organization
Contact information
Practice address
5415 AIRPORT DR, CHARLOTTE, NC 28208-5733
(980) 318-3125
Mailing address
1838 NANTUCKETT LN APT 102, CHARLOTTE, NC 28270-2393
(980) 318-3125
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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