Organization
JDI LIFE SKILLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY TYLER (CEO)
(336) 324-1617
Entity
Organization
Contact information
Practice address
10516 KETTERING DR, 607, CHARLOTTE, NC 28226-4796
(336) 324-1617
Mailing address
10516 KETTERING DR, 607, CHARLOTTE, NC 28226-4796
(336) 324-1617
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/25/2011
Last updated
05/25/2011
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