Organization
MECKLENBURG OPEN DOOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD G PAYTON (EXECUTIVE DIRECTOR)
(704) 525-3255
Entity
Organization
Contact information
Practice address
714 MCALWAY RD, CHARLOTTE, NC 28211-1414
(704) 364-0432
Mailing address
1515 MOCKINGBIRD LN, SUITE #1015, CHARLOTTE, NC 28209-3236
(704) 525-3255
(704) 525-0949
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-060-996
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805654
—
NC
Enumeration date
03/13/2007
Last updated
08/22/2020
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