| Mecklenburg Open Door, Inc. | |
|
1518 Briar Creek Rd Charlotte NC 28205-5576 | |
| (704) 537-4544 | |
| (704) 537-4430 |
| Full Name | Mecklenburg Open Door, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1518 Briar Creek Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Edward G Payton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7045253255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mecklenburg Open Door, Inc. 1515 Mockingbird Ln Sutie 1015 Charlotte NC 28209-3236 Ph: (704) 525-3255 | Mecklenburg Open Door, Inc. 1518 Briar Creek Rd Charlotte NC 28205-5576 Ph: (704) 537-4544 |
| NPI Number | 1285767665 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285767665 | NPI | - | NPPES |
| 7803476 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-060-454 (North Carolina) | Primary |
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