Healthcare Provider Details

I. General information

NPI: 1497673370
Provider Name (Legal Business Name): TMNC KIDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 BRAMBLEWOOD DR
SHELBY NC
28152-9092
US

IV. Provider business mailing address

2408 BRAMBLEWOOD DR
SHELBY NC
28152-9092
US

V. Phone/Fax

Practice location:
  • Phone: 704-477-1233
  • Fax:
Mailing address:
  • Phone: 704-477-1233
  • 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: MAURICE A CORRY
Title or Position: CEO
Credential:
Phone: 704-477-1233