MEDICARE: VOCA CORPORATION OF NORTH CAROLINA, INC.

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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629198619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOCA CORPORATION OF NORTH CAROLINA, INC.

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:	502-381-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 TODDVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-2438
Country	:	US
Telephone Number	:	743-918-0771
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT MGR
Name	:	ANGIE MATTINGLY
Credential	:
Telephone Number	:	502-381-3579

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	06/04/2021

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