Organization
BLAKE RESOURCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GRACE SMITH (PRINCIPAL)
(704) 231-3191
Entity
Organization
Contact information
Practice address
1000 BAXTER ST, CHARLOTTE, NC 28204-2859
(704) 231-3191
(888) 463-6116
Mailing address
11418 FRANK LITTLE CT, CHARLOTTE, NC 28269-2137
(704) 231-3191
(888) 463-6116
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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