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General NPI Number Information
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NPI Number | 1376307892
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIVE CARE HOMES, LLC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 2422 CHAPELTON DR
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City | CHARLOTTE
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State | NC
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Zip | 28214-9408
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Country | US
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Telephone | 919-609-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 428 E 4TH ST STE 404
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City | CHARLOTTE
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State | NC
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Zip | 28202-2497
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Country | US
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Telephone | 919-609-2494
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT LEWIS JR.
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Credential |
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Telephone | 919-609-2494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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