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General NPI Number Information
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NPI Number | 1417562562
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Entity Type | Organization
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Legal Business Name | RESIDENTIAL ADOLESCENT COMMUNITY SERVICES INC.
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 443 N. SUMMIT AVE CHARLOTTE
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City | CHARLOTTE
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State | NC
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Zip | 28216-2821
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Country | US
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Telephone | 980-938-4354
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Fax |
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Provider Business Mailing Address
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Address Line | 443 N. SUMMIT AVE CHARLOTTE
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City | CHARLOTTE
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State | NC
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Zip | 28216-3320
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Country | US
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Telephone | 980-938-4354
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTOINETTE L THORNTON
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Credential |
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Telephone | 704-890-0666
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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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Taxonomy #2
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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 |
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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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