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NPI Code Detail

MEDICARE: THOMPSON CHILD AND FAMILY FOCUS

MEDICARE: THOMPSON CHILD AND FAMILY FOCUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)SC
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1417278169
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMPSON CHILD AND FAMILY FOCUS
Provider Business Mailing Address
First Line : 6800 SAINT PETER'S LANE
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-7185
Country : US
Telephone Number : 704-536-0375
Fax Number : 704-531-9266
Provider Business Practice Location Address
First Line : 852 GOLD HILL ROAD
Second Line : SUITE 204
City : FORT MILL
State : SC
Zip : 29708-6965
Country : US
Telephone Number : 803-548-4044
Fax Number : 803-548-4074
Authorized Official
Title or Position : ACCOUNTS RECEIVABLE
Name : MARY ELIZABETH PORRAS KANTROWITZ
Credential :
Telephone Number : 704-536-0375
Provider Enumeration Date : 06/17/2010
Last Update Date : 07/21/2022

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Directions to “THOMPSON CHILD AND FAMILY FOCUS ” Practice Location

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