| Impact Carolina Services, Inc | |
|
2848 Queen City Dr Ste G Charlotte NC 28208-2739 | |
| (704) 405-1617 | |
| (704) 405-1619 |
| Full Name | Impact Carolina Services, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2848 Queen City Dr Ste G, Charlotte, North Carolina |
| Authorized Official Name and Position | Joseph Adedokun (DIRECTOR/CEO) |
| Authorized Official Contact | 7044051617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Carolina Services, Inc 2848 Queen City Dr Ste G Charlotte NC 28208-2739 Ph: (704) 405-1617 | Impact Carolina Services, Inc 2848 Queen City Dr Ste G Charlotte NC 28208-2739 Ph: (704) 405-1617 |
| NPI Number | 1619285756 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 09/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619285756 | NPI | - | NPPES |
| 6006650 | Medicaid | NC |
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