Organization
ISLEEPPCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALANA LORD (PRESIDENT)
(704) 222-5222
Entity
Organization
Contact information
Practice address
1820 MARIBEL AVE, CHARLOTTE, NC 28216-4564
(704) 222-5222
Mailing address
1820 MARIBEL AVE, CHARLOTTE, NC 28216-4564
(704) 222-5222
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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