| Mecklenburg Open Door, Inc. | |
|
3711 Carmel Forest Dr Charlotte NC 28226-8117 | |
| (704) 542-8727 | |
| (704) 542-9198 |
| Full Name | Mecklenburg Open Door, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3711 Carmel Forest Dr, 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. 3711 Carmel Forest Dr Charlotte NC 28226-8117 Ph: (704) 542-8727 |
| NPI Number | 1750414132 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750414132 | NPI | - | NPPES |
| 7802714 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-060-248 (North Carolina) | Primary |
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