Organization
PRISM LITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIKA TRIMNELL (EXECUTIVE DIRECTOR)
(808) 282-5358
Entity
Organization
Contact information
Practice address
301 OLD BELL RD, CHARLOTTE, NC 28270-2793
(808) 282-5358
Mailing address
7804C FAIRVIEW RD STE 241, CHARLOTTE, NC 28226-4945
(808) 282-5358
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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