Organization
QUEST PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYNN BAKER (EXECUTIVE DIRECTOR)
(704) 537-4730
Entity
Organization
Contact information
Practice address
7911 RUSTY PLOW CT, CHARLOTTE, NC 28216-6837
(704) 537-4730
Mailing address
2329 E WT HARRIS BLVD, CHARLOTTE, NC 28213-5186
(704) 537-4730
(704) 537-4731
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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