Organization
FIRST STEP DIRECT CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN LAVERN GRAHAM (ADMINISTRATIVE PROGRAM DIRECTOR)
(803) 280-9263
Entity
Organization
Contact information
Practice address
320 WINDING CANYON DR, CHARLOTTE, NC 28214-5013
(704) 395-2432
(704) 395-2432
Mailing address
PO BOX 668683, CHARLOTTE, NC 28266-8683
(704) 395-2432
(704) 395-2432
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL060709
NC
Other
Enumeration date
02/07/2007
Last updated
07/24/2007
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