| Prosperity Path, Llc | |
|
6638 Farmingdale Dr Charlotte NC 28212-4420 | |
| (704) 615-3458 | |
| Not Available |
| Full Name | Prosperity Path, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6638 Farmingdale Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Jonathan Christopher Lilley (CEO) |
| Authorized Official Contact | 7046153458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosperity Path, Llc 12430 Clackwyck Ln Ste 704 Charlotte NC 28262-1628 Ph: (704) 615-3458 | Prosperity Path, Llc 6638 Farmingdale Dr Charlotte NC 28212-4420 Ph: (704) 615-3458 |
| NPI Number | 1689348468 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 08/23/2021 |
| Certification Date | 08/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689348468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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