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General NPI Number Information
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NPI Number | 1477892107
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Entity Type | Organization
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Legal Business Name | R.E.D. SERVICES OF NC
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 7645 TURNEY RD
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City | CHARLOTTE
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State | NC
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Zip | 28269-0122
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Country | US
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Telephone | 704-281-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 7645 TURNEY ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28269
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CERTIFIED SUBSTANCE ABUSE COUNSELOR
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Name | MS. NEPHALIS DELORIS GRAVES
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Credential | CSAC, QSAP
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Telephone | 704-281-3365
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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 | 2024
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2024
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 2024
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License Number State | NC
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