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General NPI Number Information
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NPI Number | 1184574089
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Entity Type | Organization
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Legal Business Name | RAISING OUR OUTLOOK THROUGH SUPPORT
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 4400 HOVIS RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-2058
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Country | US
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Telephone | 864-492-1484
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 HOVIS RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-2058
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Country | US
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Telephone | 864-492-1484
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARCUS ALLEN TALLEY
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Credential | BS
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Telephone | 980-319-4203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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