| Habitual Roots Inc. | |
|
1348 Green Oaks Ln Apt N Charlotte NC 28205-8334 | |
| (336) 971-1719 | |
| Not Available |
| Full Name | Habitual Roots Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1348 Green Oaks Ln Apt N, Charlotte, North Carolina |
| Authorized Official Name and Position | Justin Ervin (EXECUTIVE DIRECTOR / FOUNDER) |
| Authorized Official Contact | 3369711719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Habitual Roots Inc. Po Box 189017 Charlotte NC 28218-9017 Ph: (844) 355-0555 | Habitual Roots Inc. 1348 Green Oaks Ln Apt N Charlotte NC 28205-8334 Ph: (336) 971-1719 |
| NPI Number | 1801671573 |
|---|---|
| Provider Enumeration Date | 08/30/2023 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801671573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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