Organization
CAROLINA COMMUNITY GROUP TRIAD
Active
Parent organization
CAROLINA COMMUNITY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINA COMMUNITY GROUP
Authorized official
IVORY D BETHEA (DIRECTOR)
(704) 582-1793
Entity
Organization
Contact information
Practice address
2818 QUEEN CITY DR STE N, CHARLOTTE, NC 28208-2736
(704) 912-4505
Mailing address
2818 QUEEN CITY DR STE N, CHARLOTTE, NC 28208-2736
(704) 912-4505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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