Healthcare Provider Details

I. General information

NPI: 1891494092
Provider Name (Legal Business Name): THE BLANCHARD INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10352 PARK RD
CHARLOTTE NC
28210-8401
US

IV. Provider business mailing address

10352 PARK RD
CHARLOTTE NC
28210-8401
US

V. Phone/Fax

Practice location:
  • Phone: 704-288-1097
  • Fax: 704-659-4433
Mailing address:
  • Phone: 704-288-1097
  • Fax: 704-659-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WARD BLANCHARD
Title or Position: CEO
Credential:
Phone: 252-216-9374