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Organization

FOOTPRINTS CAROLINA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD ANDERSON BS (CEO)
(704) 884-2500
Entity
Organization

Contact information

Practice address
311 MCBEE ST, LINCOLNTON, NC 28092-2818
(704) 735-5633
(704) 735-1924
Mailing address
2020 REMOUNT RD, GASTONIA, NC 28054-7476
(704) 884-2500
(704) 524-2095

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5903099
NC
05
6005759
NC
05
8300450
NC
05
8300450B
NC
05
8300450G
NC
05
8300450H
NC
Enumeration date
11/26/2007
Last updated
12/03/2007
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