MEDICARE: THEIR4U FOUNDATION

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1326273475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THEIR4U FOUNDATION

Provider Business Mailing Address
First Line	:	4445 DEVONHILL LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-4076
Country	:	US
Telephone Number	:	980-225-7775
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 E INDEPENDENCE BLVD
Second Line	:	SUITE 704
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-5400
Country	:	US
Telephone Number	:	980-225-7775
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. JOVONNIA G MCCRAY
Credential	:
Telephone Number	:	980-225-7775

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	05/19/2009

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Directions to “THEIR4U FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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