Healthcare Provider Details

I. General information

NPI: 1093756819
Provider Name (Legal Business Name): ANUVIA PREVENTION & RECOVERY, CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

IV. Provider business mailing address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

V. Phone/Fax

Practice location:
  • Phone: 704-376-7447
  • Fax: 704-376-2172
Mailing address:
  • Phone: 704-376-7447
  • Fax: 704-376-2172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHL-060-1079
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMHL-060-1079
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHL-060-1079
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberMHL-060-014
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-060-1079
License Number StateNC

VIII. Authorized Official

Name: MR. LARRY SNIDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 704-376-7447