Healthcare Provider Details

I. General information

NPI: 1790721785
Provider Name (Legal Business Name): THE FAMILY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E 7TH ST
CHARLOTTE NC
28204-3340
US

IV. Provider business mailing address

2200 E 7TH ST
CHARLOTTE NC
28204-3340
US

V. Phone/Fax

Practice location:
  • Phone: 704-376-7180
  • Fax: 704-376-0904
Mailing address:
  • Phone: 704-376-7180
  • Fax: 704-376-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD SIMPSON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 704-376-7180