Organization
FOOTPRINTS CAROLINA, INC
Active
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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