| Stsdavisllc | |
|
431 Amhurst St Sw Concord NC 28025-8838 | |
| (704) 890-6164 | |
| Not Available |
| Full Name | Stsdavisllc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 431 Amhurst St Sw, Concord, North Carolina |
| Authorized Official Name and Position | Shannon Marie Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7048906164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stsdavisllc 431 Amhurst St Sw Concord NC 28025-8838 Ph: (704) 890-6164 | Stsdavisllc 431 Amhurst St Sw Concord NC 28025-8838 Ph: (704) 890-6164 |
| NPI Number | 1982469268 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 05/01/2024 |
| Certification Date | 05/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982469268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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