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General NPI Number Information
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NPI Number | 1023152287
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Entity Type | Organization
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Legal Business Name | JEMSEK CHARM PROJECT
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14330 OAK HILL PARK LN
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3314
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Country | US
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Telephone | 704-659-8500
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Fax | 704-659-8518
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Provider Business Mailing Address
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Address Line | PO BOX 3413
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City | HUNTERSVILLE
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State | NC
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Zip | 28070-3413
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Country | US
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Telephone | 704-659-8500
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Fax | 704-659-8518
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BRENDA DAUGHERTY
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Credential |
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Telephone | 704-659-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 8700425
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License Number State | NC
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