Healthcare Provider Details

I. General information

NPI: 1346169620
Provider Name (Legal Business Name): THELMA RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 EAVES LN
CHARLOTTE NC
28215-4096
US

IV. Provider business mailing address

4341 EAVES LN
CHARLOTTE NC
28215-4096
US

V. Phone/Fax

Practice location:
  • Phone: 646-280-5656
  • Fax:
Mailing address:
  • Phone: 646-280-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHANETTE BROWN
Title or Position: OWNER
Credential:
Phone: 646-280-5656