Organization
SANKOFA 34 MENS HEALING HUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERWIN SAMUEL ISAIAH II LCMHC-S (OWNER)
(704) 281-6356
Entity
Organization
Contact information
Practice address
1914 BRUNSWICK AVE STE 1B, CHARLOTTE, NC 28207-1891
(704) 281-6356
(910) 973-0257
Mailing address
1914 BRUNSWICK AVE STE 1B, CHARLOTTE, NC 28207-1891
(704) 281-6356
(910) 973-0257
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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