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General NPI Number Information
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NPI Number | 1013201896
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Entity Type | Organization
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Legal Business Name | COMMUNITY EMBRACE
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 5309 E INDEPENDENCE BLVD STE E
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City | CHARLOTTE
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State | NC
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Zip | 28212-0542
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Country | US
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Telephone | 980-229-2907
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Fax |
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Provider Business Mailing Address
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Address Line | 5309 E INDEPENDENCE BLVD STE E
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City | CHARLOTTE
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State | NC
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Zip | 28212-0542
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DAVID MCNEIL
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Credential |
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Telephone | 980-229-2907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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