Organization
WILLOWS NEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVION DOUGLAS (OWNER)
(704) 430-1038
Entity
Organization
Contact information
Practice address
610 E 7TH ST, CHARLOTTE, NC 28202-2923
(704) 430-1038
Mailing address
13724 RIDING HILL AVE, CHARLOTTE, NC 28213-4251
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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