Healthcare Provider Details

I. General information

NPI: 1194119131
Provider Name (Legal Business Name): CANO FAMILY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 J N PEASE PL STE 101
CHARLOTTE NC
28262-4509
US

IV. Provider business mailing address

2812 ISLAND POINT DR NW
CONCORD NC
28027-2537
US

V. Phone/Fax

Practice location:
  • Phone: 980-313-3020
  • Fax: 704-980-8023
Mailing address:
  • Phone: 980-621-8401
  • Fax: 704-980-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC009256
License Number StateNC

VIII. Authorized Official

Name: ANGELA MARIA CANO-JOHNSON
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 980-621-8401