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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVELYN DILLARD CADC (OWNER)
(704) 402-9176
Entity
Organization

Contact information

Practice address
4724 MAPLE KNOLL AVE, CHARLOTTE, NC 28212-4735
(704) 402-9176
Mailing address
113 RIVERIA RD, MOORESVILLE, NC 28117-8974
(704) 402-9176

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
251B00000X
Case Management Agency
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
04/22/2025
Last updated
06/29/2025
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