Organization
HEALTHSTAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILEMON MBOINI NGOH (CEO)
(859) 536-3360
Entity
Organization
Contact information
Practice address
13136 SUDWICK LN, CHARLOTTE, NC 28278-8677
(859) 536-3360
Mailing address
13136 SUDWICK LN, CHARLOTTE, NC 28278-8677
(859) 536-3360
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/13/2024
Last updated
06/03/2025
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