Organization
A KEY TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PAMELA ANNETTE FULLER (OWNER/ EXECUTIVE DIRECTOR)
(704) 236-1377
Entity
Organization
Contact information
Practice address
2215 LAWRY RUN DR APT 201, CHARLOTTE, NC 28273-3508
(704) 236-1377
Mailing address
2215 LAWRY RUN DR APT 201, CHARLOTTE, NC 28273-3508
(704) 236-1377
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
251C00000X
Developmentally Disabled Services Day Training Agency
—
NC
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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