| Blue Stream Healthcare, Pllc | |
|
4037 East Independence Bvld Charlotte NC 28205-0510 | |
| (385) 232-9543 | |
| Not Available |
| Full Name | Blue Stream Healthcare, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4037 East Independence Bvld, Charlotte, North Carolina |
| Authorized Official Name and Position | Clarence Taylor (CEO) |
| Authorized Official Contact | 3852329543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Stream Healthcare, Pllc 2825 Lee St Charlotte NC 28214-2717 Ph: (385) 232-9543 | Blue Stream Healthcare, Pllc 4037 East Independence Bvld Charlotte NC 28205-0510 Ph: (385) 232-9543 |
| NPI Number | 1144054586 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144054586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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