Organization
CONQUER LIFE RESTORATIVE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAKA MOUZON (SOCIAL WORKER)
(704) 614-4082
Entity
Organization
Contact information
Practice address
7671 PETREA LN, CHARLOTTE, NC 28227-1060
(704) 614-4082
Mailing address
7671 PETREA LN, CHARLOTTE, NC 28227-1060
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
08/07/2026
Last updated
08/07/2026
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