Organization
TARHEEL RESIDENTIAL TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUNIR MOHAMMED BSW, MS (DIRECTOR)
(704) 506-3575
Entity
Organization
Contact information
Practice address
7921 CHESTNUT RIDGE DR, CHARLOTTE, NC 28215-5517
(704) 536-4595
(704) 645-8900
Mailing address
PO BOX 43537, CHARLOTTE, NC 28215-0040
(704) 536-4595
(704) 645-8900
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-060-632
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603921
—
NC
Enumeration date
02/27/2007
Last updated
08/22/2020
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