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11330 Vanstory Dr Ste 114f Huntersville NC 28078-8146 | |
| (704) 897-2584 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11330 Vanstory Dr Ste 114f, Huntersville, North Carolina |
| Authorized Official Name and Position | Bradford John Cary-coleman (CEO) |
| Authorized Official Contact | 3363405138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11330 Vanstory Dr Ste 114f Huntersville NC 28078-8146 Ph: (704) 897-2584 | 11330 Vanstory Dr Ste 114f Huntersville NC 28078-8146 Ph: (704) 897-2584 |
| NPI Number | 1235877598 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/26/2022 |
| Certification Date | 05/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235877598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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