Organization
PRODIGY SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUTHER SHERARD DOUGLAS (PRESIDENT)
(704) 231-4516
Entity
Organization
Contact information
Practice address
416 MCCULLOUGH DR., SUITE 120, CHARLOTTE, NC 28262
(704) 231-4516
(704) 919-5690
Mailing address
416 MCCULLOUGH DR., SUITE 120, CHARLOTTE, NC 28262
(704) 971-4270
(704) 971-3274
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/17/2007
Last updated
02/17/2011
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