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General NPI Number Information
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NPI Number | 1982956074
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Entity Type | Organization
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Legal Business Name | MECKLENBURG COUNTY AREA MENTAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 429 BILLINGSLEY RD SAM BILLINGS CENTER
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City | CHARLOTTE
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State | NC
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Zip | 28211-1007
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Country | US
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Telephone | 704-336-3067
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Fax | 704-336-5105
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Provider Business Mailing Address
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Address Line | 429 BILLINGSLEY RD SAM BILLINGS CENTER
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City | CHARLOTTE
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State | NC
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Zip | 28211-1007
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Country | US
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Telephone | 704-336-3067
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Fax | 704-336-5105
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CONSTANCE COOK MELE
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Credential | PMHCNS-BC,CARN-AP
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Telephone | 704-336-7155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NC
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | MHL-060-185
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License Number State | NC
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