| Mecklenburg Open Door, Inc. | |
|
1211 Robinhood Cir Charlotte NC 28227-4036 | |
| (704) 563-8894 | |
| (704) 563-8619 |
| Full Name | Mecklenburg Open Door, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1211 Robinhood Cir, 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 Suite 1015 Charlotte NC 28209-3236 Ph: (704) 525-3255 | Mecklenburg Open Door, Inc. 1211 Robinhood Cir Charlotte NC 28227-4036 Ph: (704) 563-8894 |
| NPI Number | 1407989874 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407989874 | NPI | - | NPPES |
| 7805619 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-060-993 (North Carolina) | Primary |
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