MEDICARE: CRAFTS & ARTS THERAPEUTIC SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1316661259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAFTS & ARTS THERAPEUTIC SERVICES INC.

Provider Business Mailing Address
First Line	:	2204 VANDERBILT RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-2456
Country	:	US
Telephone Number	:	704-390-3075
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 VANDERBILT RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-2456
Country	:	US
Telephone Number	:	704-390-3075
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	JOANN SMITH
Credential	:
Telephone Number	:	704-390-3075

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

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