Organization
HOPE COMMUNITY SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LETISHAL JUANITE KELLY (OWNER)
(704) 493-0466
Entity
Organization
Contact information
Practice address
9635 SOUTHERN PINE BLVD STE 127, CHARLOTTE, NC 28273-5563
(704) 493-0466
Mailing address
9635 SOUTHERN PINE BLVD STE 127, CHARLOTTE, NC 28273-5563
(704) 493-0466
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/02/2008
Last updated
12/07/2023
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