Healthcare Provider Details

I. General information

NPI: 1154706307
Provider Name (Legal Business Name): ANUVIA PREVENTION AND RECOVERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 BILLINGSLEY RD
CHARLOTTE NC
28211-1007
US

IV. Provider business mailing address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

V. Phone/Fax

Practice location:
  • Phone: 704-376-7447
  • Fax: 704-376-3384
Mailing address:
  • Phone: 704-376-7447
  • Fax: 704-376-3384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL 060-1300
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberMHL-060-1300
License Number StateNC

VIII. Authorized Official

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