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Organization

JUST LIKE HOME DEVELOPMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NANCY NEWSOME (DIRECTOR)
(704) 713-4618
Entity
Organization

Contact information

Practice address
6527 FARMWAY PL, CHARLOTTE, NC 28215-1701
(704) 713-4618
Mailing address
6527 FARMWAY PL, CHARLOTTE, NC 28215-1701
(704) 713-4618

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
60002779
NC
347C00000X
Private Vehicle
60002779
NC

Other

Enumeration date
01/06/2009
Last updated
01/06/2009
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