| Adult Homeless Substance Abuse Trtmnt-offsite (women's) | |
|
534 Spratt St Charlotte NC 28206-2969 | |
| (704) 432-2958 | |
| (704) 432-4599 |
| Full Name | Adult Homeless Substance Abuse Trtmnt-offsite (women's) |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 534 Spratt St, Charlotte, North Carolina |
| Authorized Official Name and Position | Grayce Crockett (AREA DIRECTOR) |
| Authorized Official Contact | 7043368638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Homeless Substance Abuse Trtmnt-offsite (women's) 429 Billingsley Rd Charlotte NC 28211-1007 Ph: (794) 336-2023 | Adult Homeless Substance Abuse Trtmnt-offsite (women's) 534 Spratt St Charlotte NC 28206-2969 Ph: (704) 432-2958 |
| NPI Number | 1790860807 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790860807 | NPI | - | NPPES |
| 8301098G | Medicaid | NC | |
| 8301098P | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-060-722 (North Carolina) | Primary |
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