Healthcare Provider Details

I. General information

NPI: 1841473105
Provider Name (Legal Business Name): REINTEGRATION TARGETING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N TRYON ST
CHARLOTTE NC
28206-2704
US

IV. Provider business mailing address

1801 N TRYON ST
CHARLOTTE NC
28206-2704
US

V. Phone/Fax

Practice location:
  • Phone: 704-405-8568
  • Fax: 704-405-8569
Mailing address:
  • Phone: 704-405-8568
  • Fax: 704-405-8569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIONETTE O COLE
Title or Position: VICE PRESIDENT & EXECUTIVE DIRECTOR
Credential:
Phone: 704-405-8568