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General NPI Number Information
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NPI Number | 1356246409
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Entity Type | Organization
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Legal Business Name | ESCAPE MENTORING
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 2404 WILDBURNE CT
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City | CHARLOTTE
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State | NC
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Zip | 28262-9220
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Country | US
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Telephone | 704-495-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 2404 WILDBURNE CT
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City | CHARLOTTE
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State | NC
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Zip | 28262-9220
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Country | US
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Telephone | 704-495-4379
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RENE T BREWER
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Credential | LCMHC
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Telephone | 704-495-4379
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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 | NULL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NULL
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Taxonomy #6
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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 | NULL
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Taxonomy #7
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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 | NULL
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