Healthcare Provider Details
I. General information
NPI: 1104133875
Provider Name (Legal Business Name): TRUE CARE OUTPATIENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2010
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4410 W ARGYLE DR
CHARLOTTE NC
28213-6171
US
IV. Provider business mailing address
4410 W ARGYLE DR
CHARLOTTE NC
28213-6171
US
V. Phone/Fax
- Phone: 704-900-7744
- Fax:
- Phone: 704-900-7744
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
KING
Title or Position: OWNER
Credential:
Phone: 704-900-7744