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2843 Ridge Rd Indian Trail NC 28079-6703 | |
| (704) 289-1965 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2843 Ridge Rd, Indian Trail, North Carolina |
| Authorized Official Name and Position | Craig Bass (PRESIDENT & CEO) |
| Authorized Official Contact | 7043668712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6220 Thermal Rd Charlotte NC 28211-5630 Ph: (704) 366-8712 | 2843 Ridge Rd Indian Trail NC 28079-6703 Ph: (704) 289-1965 |
| NPI Number | 1831500453 |
|---|---|
| Provider Enumeration Date | 05/16/2014 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831500453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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