Organization
ERVIN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANGELA M ERVIN (EXECUTIVE DIRECTOR)
(704) 426-9457
Entity
Organization
Contact information
Practice address
1069 BRIANNA WAY, CHARLOTTE, NC 28217-1261
(704) 426-9457
Mailing address
2022 SYRACUSE DR, CHARLOTTE, NC 28216-4421
(704) 426-9457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHL-060-1010
NC
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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