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General NPI Number Information
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NPI Number | 1497473086
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Entity Type | Organization
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Legal Business Name | CEDRIC DEAN HOLDINGS INC.
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 2001 CATHERINE SIMMONS AVE
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City | CHARLOTTE
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State | NC
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Zip | 28216-4677
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Country | US
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Telephone | 704-492-1533
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Fax |
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Provider Business Mailing Address
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Address Line | 5502 MCCHESNEY DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-7188
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Country | US
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Telephone | 704-492-5509
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH PRACTITIONER
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Name | MR. CEDRIC DEAN
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Credential | CPSS
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Telephone | 704-492-5509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 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 #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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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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