| Provizions Transitional Housing | |
|
424 Lakewood Ave Charlotte NC 28208-3148 | |
| (704) 963-7552 | |
| (774) 307-2797 |
| Full Name | Provizions Transitional Housing |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 424 Lakewood Ave, Charlotte, North Carolina |
| Authorized Official Name and Position | Latasha U Pross (CEO) |
| Authorized Official Contact | 7049637552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provizions Transitional Housing 5835 Executive Center Dr Ste 101f Charlotte NC 28212-8901 Ph: (704) 963-7552 | Provizions Transitional Housing 424 Lakewood Ave Charlotte NC 28208-3148 Ph: (704) 963-7552 |
| NPI Number | 1528513983 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528513983 | NPI | - | NPPES |
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