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General NPI Number Information
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NPI Number | 1164085684
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Entity Type | Organization
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Legal Business Name | CONECTANDO FAMILIAS SDG, INC.
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 5200 PARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28209-3650
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Country | US
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Telephone | 704-526-6072
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 BROOK VALLEY RUN
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City | MONROE
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State | NC
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Zip | 28110-6303
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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 | FOUNDER/CEO
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Name | MRS. CATHERINE GOMEZ-MENDEZ
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Credential | MSW, LCSW
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Telephone | 704-526-6072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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