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General NPI Number Information
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NPI Number | 1174556401
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Entity Type | Organization
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Legal Business Name | PURPOSE AND PROMISE, INC.
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10925 DAVID TAYLOR DR SUITE 100
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City | CHARLOTTE
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State | NC
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Zip | 28262-1040
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Country | US
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Telephone | 704-944-5544
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Fax | 704-943-0746
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Provider Business Mailing Address
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Address Line | 3611 MOUNT HOLLY HUNTERSVILLE RD SUITE 204-123
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City | CHARLOTTE
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State | NC
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Zip | 28216-8636
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Country | US
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Telephone | 704-944-5544
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Fax | 704-943-0746
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. KEITH D WIGGINS
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Credential |
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Telephone | 704-944-5544
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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 | 8700457
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License Number State | NC
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