Organization
MECKLENBURG OPEN DOOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD G PAYTON (EXECUTIVE DIRECTOR)
(704) 525-3255
Entity
Organization
Contact information
Practice address
3950 FREEDOM DR, CHARLOTTE, NC 28208-2292
(704) 398-9302
(704) 398-9302
Mailing address
1515 MOCKINGBIRD LN, SUITE 1015, CHARLOTTE, NC 28209-3236
(704) 525-3255
(704) 525-0949
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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