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General NPI Number Information
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NPI Number | 1295210409
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Entity Type | Organization
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Legal Business Name | BAITUL HEMAYAH, INC.
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 4301 SHAMROCK DR
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City | CHARLOTTE
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State | NC
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Zip | 28215-3915
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Country | US
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Telephone | 704-247-3790
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 SHAMROCK DR
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City | CHARLOTTE
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State | NC
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Zip | 28215-3915
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Country | US
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Telephone | 704-247-3790
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Fax |
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Authorized Official
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Title or Position | DOMESTIC VIOLENCE SPECIALIST
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Name | SAIDAH SUDAN
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Credential | DVS
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Telephone | 704-247-3790
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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 |
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License Number State |
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