Organization
CAROLINA'S THERAPY SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON WAYNE ECCLESTON II LCSW (OWNER)
(704) 608-0445
Entity
Organization
Contact information
Practice address
1009 WICKERBY CT, INDIAN TRAIL, NC 28079-3738
(704) 608-0445
Mailing address
PO BOX 634, INDIAN TRAIL, NC 28079-0634
(704) 608-0445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003091
—
NC
Enumeration date
12/17/2007
Last updated
12/17/2007
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