Organization
BEHAVIORAL HEALTH CENTER CMC RANDOLPH
Active
Other names
Diagnostic Assessment Services-Access
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS E. GETTELMAN PH.D. (ASSISTANT VICE PRESIDENT)
(704) 444-2406
Entity
Organization
Contact information
Practice address
1216 N TRYON ST, BEHAVIORAL HEALTH CENTER CMC RANDOLPH, CHARLOTTE, NC 28206-3256
(704) 336-6570
(704) 336-3623
Mailing address
501 BILLINGSLEY RD, BEHAVIORAL HEALTH CENTER CMC RANDOLPH, CHARLOTTE, NC 28211-1009
(704) 358-2710
(704) 358-2938
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
H0071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300446G
—
NC
Enumeration date
06/29/2007
Last updated
10/18/2007
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