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9206 Hollow Bend Dr Huntersville NC 28078-5095 | |
| (305) 707-8615 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 9206 Hollow Bend Dr, Huntersville, North Carolina |
| Authorized Official Name and Position | Carmen Lidia Bolivar (OWNER) |
| Authorized Official Contact | 3057078615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
690 Sw 1st Ct Apt 2709 Miami FL 33130-2928 Ph: (305) 707-8615 | 9206 Hollow Bend Dr Huntersville NC 28078-5095 Ph: (305) 707-8615 |
| NPI Number | 1912524216 |
|---|---|
| Provider Enumeration Date | 07/02/2020 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912524216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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