| Ichep Llc | |
|
9635 Southern Pine Blvd Ste 126 Charlotte NC 28273-5558 | |
| (803) 477-7928 | |
| Not Available |
| Full Name | Ichep Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9635 Southern Pine Blvd Ste 126, Charlotte, North Carolina |
| Authorized Official Name and Position | Shaka Abdul Moustafa (CEO) |
| Authorized Official Contact | 8034777928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ichep Llc 9635 Southern Pine Blvd Suite 126 Charlotte NC 28273-5558 Ph: (803) 477-7928 | Ichep Llc 9635 Southern Pine Blvd Ste 126 Charlotte NC 28273-5558 Ph: (803) 477-7928 |
| NPI Number | 1841443181 |
|---|---|
| Provider Enumeration Date | 10/30/2008 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841443181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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