MEDICARE: CAROLINA CENTER FOR RECOVERY

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1669989554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA CENTER FOR RECOVERY

Provider Business Mailing Address
First Line	:	7349 STATESVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3702
Country	:	US
Telephone Number	:	704-844-6958
Fax Number	:	704-973-7875

Provider Business Practice Location Address
First Line	:	7349 STATESVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3702
Country	:	US
Telephone Number	:	704-844-6958
Fax Number	:	704-973-7875

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MR. RUSSELL GUCCIO
Credential	:
Telephone Number	:	704-844-6958

Provider Enumeration Date	:	01/02/2018
Last Update Date	:	04/25/2024

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Directions to “CAROLINA CENTER FOR RECOVERY ” Practice Location

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