Organization
CEDRIC DEAN HOLDINGS INC.
Active
Other names
Cedric Dean Homes, Peer Support NC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CEDRIC DEAN CPSS (BEHAVIORAL HEALTH PRACTITIONER)
(704) 492-5509
Entity
Organization
Contact information
Practice address
2001 CATHERINE SIMMONS AVE, CHARLOTTE, NC 28216-4677
(704) 492-1533
Mailing address
5502 MCCHESNEY DR, CHARLOTTE, NC 28269-7188
(704) 492-5509
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497473086
—
NC
01
—
40411529
ATYPICAL PROVIDER
NC
Enumeration date
08/18/2022
Last updated
08/13/2024
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