Organization
UNIVERSAL INSTITUTE FOR SUCCESSFUL AGING OF CAROLINAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHA SIMMONS (DIRECTOR)
(704) 390-4241
Entity
Organization
Contact information
Practice address
7701 WALLACE LN, CHARLOTTE, NC 28212-6427
(704) 390-4241
Mailing address
7701 WALLACE LN, CHARLOTTE, NC 28212-6427
(704) 390-4241
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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