| Behavioral Health Services Of Lake Norman | |
|
107 Kilson Dr Suite 202 Mooresville NC 28117-8162 | |
| (704) 660-8321 | |
| (704) 660-8323 |
| Full Name | Behavioral Health Services Of Lake Norman |
|---|---|
| Speciality | Counselor - Professional |
| Location | 107 Kilson Dr, Mooresville, North Carolina |
| Authorized Official Name and Position | Michael E Rife (OWNER) |
| Authorized Official Contact | 7046608321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Services Of Lake Norman 107 Kilson Dr Suite 202 Mooresville NC 28117-8162 Ph: (704) 660-8321 | Behavioral Health Services Of Lake Norman 107 Kilson Dr Suite 202 Mooresville NC 28117-8162 Ph: (704) 660-8321 |
| NPI Number | 1619331113 |
|---|---|
| Provider Enumeration Date | 04/11/2016 |
| Last Update Date | 04/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619331113 | NPI | - | NPPES |
| 6103394 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2215 (North Carolina) | Primary |
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