| Mercy Op Diagnostic Assessment | |
|
1816 Lyndhurst Avenue Behavioral Health Center-mercy Horizons Outpatient Svcs Charlotte NC 28203-5104 | |
| (704) 446-0392 | |
| (704) 348-4057 |
| Full Name | Mercy Op Diagnostic Assessment |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1816 Lyndhurst Avenue, Charlotte, North Carolina |
| Authorized Official Name and Position | Thomas E. Gettelman (ASSISTANT VICE PRESIDENT) |
| Authorized Official Contact | 7044442406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Op Diagnostic Assessment 501 Billingsley Road Behavioral Health Center Cmc Randolph Charlotte NC 28211-1009 Ph: (704) 358-2710 | Mercy Op Diagnostic Assessment 1816 Lyndhurst Avenue Behavioral Health Center-mercy Horizons Outpatient Svcs Charlotte NC 28203-5104 Ph: (704) 446-0392 |
| NPI Number | 1356521108 |
|---|---|
| Provider Enumeration Date | 11/09/2007 |
| Last Update Date | 11/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356521108 | NPI | - | NPPES |
| 8300444G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-060-577 (North Carolina) | Primary |
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