| Gbaum | |
|
5111 Nations Crossing Rd Building 8 Suite 226 Charlotte NC 28217-2126 | |
| (803) 984-0124 | |
| (704) 504-5021 |
| Full Name | Gbaum |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5111 Nations Crossing Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Jamila Safiya Nettles-felder (OWNER) |
| Authorized Official Contact | 8039840124 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gbaum 5111 Nations Crossing Rd Building 8 Suite 226 Charlotte NC 28217-2126 Ph: (803) 984-0124 | Gbaum 5111 Nations Crossing Rd Building 8 Suite 226 Charlotte NC 28217-2126 Ph: (803) 984-0124 |
| NPI Number | 1154558724 |
|---|---|
| Provider Enumeration Date | 06/22/2009 |
| Last Update Date | 06/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154558724 | NPI | - | NPPES |
| 6103628 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5431 (North Carolina) | Primary |
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