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Organization

ST. MICHAEL'S THERAPEUTIC SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TASHEEMA YVETTE SHORE BS.QP (OWNER)
(704) 701-2582
Entity
Organization

Contact information

Practice address
708 S ROWAN AVE, SPENCER, NC 28159-2146
(704) 637-3375
(704) 637-3375
Mailing address
708 S ROWAN AVE, SPENCER, NC 28159-2146
(704) 637-3375
(704) 637-3375

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-080-120
NC

Other

Enumeration date
03/01/2007
Last updated
08/22/2020
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