| Charlotte | |
|
4108 Park Rd Suite 305 Charlotte NC 28209-2259 | |
| (704) 336-6570 | |
| (704) 336-3623 |
| Full Name | Charlotte |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4108 Park Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Jennifer D Lozano (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 4049682663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlotte 1819 Peachtree Rd Ne Ste 450 Atlanta GA 30309-1848 Ph: (404) 364-2900 | Charlotte 4108 Park Rd Suite 305 Charlotte NC 28209-2259 Ph: (704) 336-6570 |
| NPI Number | 1326341819 |
|---|---|
| Provider Enumeration Date | 12/06/2010 |
| Last Update Date | 04/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326341819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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