Organization
N2 POTENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NATASHA C FETTERSON (EXECUTIVE DIRECTOR/FOUNDER)
(704) 605-4906
Entity
Organization
Contact information
Practice address
2143 LENNOX SQUARE RD, CHARLOTTE, NC 28210-9458
(704) 605-4906
(704) 552-0667
Mailing address
PO BOX 32846, CHARLOTTE, NC 28232-2846
(704) 756-7339
(704) 552-0667
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
03/23/2012
Last updated
06/24/2013
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