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General NPI Number Information
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NPI Number | 1619281144
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Entity Type | Organization
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Legal Business Name | 1CONNECT, LLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 13606 RIDING HILL AVE
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City | CHARLOTTE
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State | NC
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Zip | 28213-4255
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Country | US
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Telephone | 919-561-0883
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33522
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City | CHARLOTTE
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State | NC
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Zip | 28233-3522
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Country | US
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Telephone | 919-561-0883
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARCELETTE JOYNER
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Credential | MSW
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Telephone | 919-561-0883
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | C006232
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License Number State | NC
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