Organization
PROJECT 658
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARJORIE LUGIBIHL RN (CLINIC COORDINATOR)
(704) 733-9934
Entity
Organization
Contact information
Practice address
3622 CENTRAL AVE, CHARLOTTE, NC 28205-5638
(704) 910-5810
(980) 207-0214
Mailing address
3646 CENTRAL AVE, CHARLOTTE, NC 28205-6064
(704) 733-9934
(704) 733-9925
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
10040A
NC
163W00000X
Registered Nurse
Primary
238539
NC
Other
Enumeration date
08/05/2016
Last updated
07/21/2022
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