Organization
I EXCEL OF NORTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MATTHEW EVANS (OWNER)
(704) 293-4780
Entity
Organization
Contact information
Practice address
4822 ALBEMARLE RD, 106, CHARLOTTE, NC 28205-6668
(704) 293-4780
(704) 419-1936
Mailing address
4822 ALBEMARLE RD, 106, CHARLOTTE, NC 28205-6668
(704) 293-4780
(704) 419-1936
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
171324
NC
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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