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General NPI Number Information
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NPI Number | 1922278043
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY ALLIANCE, INC.
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 9105 MONROE RD
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City | CHARLOTTE
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State | NC
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Zip | 28270-1644
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Country | US
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Telephone | 704-536-9378
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Fax | 704-536-9359
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Provider Business Mailing Address
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Address Line | 1235 EAST BLVD #242
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City | CHARLOTTE
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State | NC
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Zip | 28203-5870
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Country | US
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Telephone | 704-536-9378
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Fax | 704-536-9359
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | SABRINA A MACK
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Credential | MSW
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Telephone | 704-536-9378
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 060-1177
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License Number State | NC
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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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