MEDICARE: VOCA CORPORATION OF NORTH CAROLINA

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

General Provider Information

NPI Number	:	1861822314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOCA CORPORATION OF NORTH CAROLINA

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

Provider Business Practice Location Address
First Line	:	4109 ENOCH DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2578
Country	:	US
Telephone Number	:	704-519-0077
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT MANAGER
Name	:	MS. ANGIE MATTINGLY
Credential	:
Telephone Number	:	502-394-2100

Provider Enumeration Date	:	11/20/2013
Last Update Date	:	06/04/2021

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