| Carolina Outreach, Llc | |
|
2508 April Liu Ln Apt 311 Charlotte NC 28213-6966 | |
| (704) 332-8787 | |
| Not Available |
| Full Name | Carolina Outreach, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2508 April Liu Ln Apt 311, Charlotte, North Carolina |
| Authorized Official Name and Position | James Mitchell Vedder (CFO) |
| Authorized Official Contact | 7038441007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Outreach, Llc 2670 Durham Chapel Hill Blvd Durham NC 27707-2829 Ph: (720) 402-2296 | Carolina Outreach, Llc 2508 April Liu Ln Apt 311 Charlotte NC 28213-6966 Ph: (704) 332-8787 |
| NPI Number | 1710687967 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 03/07/2023 |
| Certification Date | 03/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710687967 | NPI | - | NPPES |
| 08300219 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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