| Mecklenburg Open Door, Inc. | |
|
245 N Cedar St Charlotte NC 28202-1212 | |
| (704) 375-0775 | |
| (704) 375-7902 |
| Full Name | Mecklenburg Open Door, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 245 N Cedar St, 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. 245 N Cedar St Charlotte NC 28202-1212 Ph: (704) 375-0775 |
| NPI Number | 1790819621 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790819621 | NPI | - | NPPES |
| 7802706 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-060-048 (North Carolina) | Primary |
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