Healthcare Provider Details

I. General information

NPI: 1578449708
Provider Name (Legal Business Name): THE LEMONADE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 BEXAR TRL
MATTHEWS NC
28105-7733
US

IV. Provider business mailing address

2202 BEXAR TRL
MATTHEWS NC
28105-7733
US

V. Phone/Fax

Practice location:
  • Phone: 704-957-3441
  • Fax:
Mailing address:
  • Phone: 704-957-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LATOYA GREEN
Title or Position: OWNER
Credential:
Phone: 704-957-3441