Organization
FOOTPRINTS CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ALAN ANDERSON (EXECUTIVE DIRECTOR)
(704) 884-2554
Entity
Organization
Contact information
Practice address
918 WEST AVE NW, LENOIR, NC 28645-5191
(828) 572-2424
(828) 572-2425
Mailing address
2020 REMOUNT RD, GASTONIA, NC 28054-7476
(704) 884-2500
(704) 524-2095
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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