| Kenan Cottage | |
|
6736 St. Peters Lane Matthews NC 28105-8458 | |
| (704) 536-0375 | |
| (704) 531-0266 |
| Full Name | Kenan Cottage |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6736 St. Peters Lane, Matthews, North Carolina |
| Authorized Official Name and Position | Cody Thomas (IT DIRECTOR) |
| Authorized Official Contact | 7045360375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenan Cottage 6800 Saint Peters Ln Matthews NC 28105-8458 Ph: (704) 536-0375 | Kenan Cottage 6736 St. Peters Lane Matthews NC 28105-8458 Ph: (704) 536-0375 |
| NPI Number | 1780668590 |
|---|---|
| Provider Enumeration Date | 12/05/2005 |
| Last Update Date | 04/02/2022 |
| Certification Date | 04/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780668590 | NPI | - | NPPES |
| 3404532 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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