MEDICARE: METRO LIFE & HUMAN 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1679762280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO LIFE & HUMAN SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 475
Second Line	:
City	:	NEWELL
State	:	NC
Zip	:	28126-0475
Country	:	US
Telephone Number	:	704-494-3007
Fax Number	:

Provider Business Practice Location Address
First Line	:	6238 KING GEORGE DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-6455
Country	:	US
Telephone Number	:	704-494-3007
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JAMES R JONES
Credential	:	MPH
Telephone Number	:	704-494-3007

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	10/19/2007

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