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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN KENNETH EDWARDS (EXECUTIVE DIRECTOR)
(704) 941-1517
Entity
Organization

Contact information

Practice address
537 W SUGAR CREEK RD STE 205, CHARLOTTE, NC 28213-6102
(704) 941-1517
Mailing address
537 W SUGAR CREEK RD STE 205, CHARLOTTE, NC 28213-6102
(704) 941-1517

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/10/2023
Last updated
07/10/2023
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