Organization
ANUVIA PREVENTION AND RECOVERY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALERIE KOPETZKY (DIRECTOR OF FINANCE AND ADMIN)
(704) 927-8802
Entity
Organization
Contact information
Practice address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 445-6900
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MHL0601300
NC
1041C0700X
Clinical Social Worker
Primary
MHL0601300
NC
363L00000X
Nurse Practitioner
MHL0601300
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00362
BCBS
NC
05
—
6005408
—
NC
Enumeration date
02/05/2016
Last updated
02/05/2016
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