Organization
CHARLIES ANGELS COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLITA RANDALL (EXECUTIVE DIRECTOR)
(412) 977-1273
Entity
Organization
Contact information
Practice address
501 HIGHWAY 90 E, LITTLE RIVER, SC 29566-9261
(704) 918-7966
Mailing address
1214 BOTTLE BRUSH LN, HARRISBURG, NC 28075-6715
(412) 977-1273
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/26/2023
Last updated
04/15/2025
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