Organization
DAVIS & DAVIS NEW BEGINNINGS#1
Active
Organization
DAVIS & DAVIS NEW BEGINNINGS#1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY EUGENE DAVIS (ADMINISTRATOR)
(704) 343-2462
Entity
Organization
Contact information
Practice address
1918 ERIE ST, CHARLOTTE, NC 28216-4703
(704) 393-0497
Mailing address
624 N DAVIDSON ST, C, CHARLOTTE, NC 28202-3103
(704) 343-2462
(704) 398-3427
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-060-855
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603499
—
NC
Enumeration date
02/08/2007
Last updated
08/22/2020
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