Healthcare Provider Details

I. General information

NPI: 1912248006
Provider Name (Legal Business Name): THE LINKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PINEY FOREST RD
DANVILLE VA
24540-2867
US

IV. Provider business mailing address

10820 TRADITION VIEW DR
CHARLOTTE NC
28269-1421
US

V. Phone/Fax

Practice location:
  • Phone: 704-258-6366
  • Fax: 704-663-5053
Mailing address:
  • Phone: 704-258-6366
  • Fax: 704-663-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VELDA SIMMONS
Title or Position: CEO-PRESIDENT
Credential:
Phone: 704-258-6366