MEDICARE: BELIEVING EVERYONE SUCCEEDS TOGETHER

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1871059444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELIEVING EVERYONE SUCCEEDS TOGETHER

Provider Business Mailing Address
First Line	:	323 SHADY GROVE RD
Second Line	:
City	:	KINGS MTN
State	:	NC
Zip	:	28086-9671
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 SHADY GROVE RD
Second Line	:
City	:	KINGS MTN
State	:	NC
Zip	:	28086-9671
Country	:	US
Telephone Number	:	704-685-6560
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LATOYA WILLIAMS
Credential	:
Telephone Number	:	704-685-6560

Provider Enumeration Date	:	02/19/2019
Last Update Date	:	02/19/2019

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Directions to “BELIEVING EVERYONE SUCCEEDS TOGETHER ” Practice Location

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