Organization
A PLACE 4 ME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LACHELLE SMITH LCSW (OWNER)
(562) 743-8166
Entity
Organization
Contact information
Practice address
3117 WHITING AVE STE 125, CHARLOTTE, NC 28205-1648
(980) 243-5595
(980) 245-5595
Mailing address
7410 NICCOLINE LN, CHARLOTTE, NC 28214-8079
(562) 743-5595
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
07/28/2020
Last updated
02/26/2024
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