Healthcare Provider Details

I. General information

NPI: 1730910522
Provider Name (Legal Business Name): I AM WE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2246 MILTON RD
CHARLOTTE NC
28215-3321
US

IV. Provider business mailing address

7533 RIDING TRAIL RD
CHARLOTTE NC
28212-4609
US

V. Phone/Fax

Practice location:
  • Phone: 980-272-1198
  • Fax:
Mailing address:
  • Phone: 516-403-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENNIS BURGESS
Title or Position: FOUNDER
Credential:
Phone: 516-403-7519