| None | |
|
2134 Capernium Rd Tr#2 Cherryville NC 28021-9478 | |
| (704) 769-4075 | |
| (704) 769-4136 |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2134 Capernium Rd, Cherryville, North Carolina |
| Authorized Official Name and Position | Annette William Burston (PARTNER OWNER) |
| Authorized Official Contact | 7044318100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 2134 Capernium Rd Tr#2 Cherryville NC 28021-9478 Ph: (704) 769-4075 | None 2134 Capernium Rd Tr#2 Cherryville NC 28021-9478 Ph: (704) 769-4075 |
| NPI Number | 1639561194 |
|---|---|
| Provider Enumeration Date | 02/20/2015 |
| Last Update Date | 02/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639561194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (North Carolina) | Secondary |
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