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Organization

NIMON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NIJIA NICOLE HOPKINS (OWNER)
(404) 664-0642
Entity
Organization

Contact information

Practice address
1635 PORTER BRANCH DR APT 208, CHARLOTTE, NC 28278-8531
(404) 664-0642
Mailing address
1635 PORTER BRANCH DR APT 208, CHARLOTTE, NC 28278-8531
(404) 664-0642

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
04/13/2026
Last updated
04/13/2026
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