MECKLENBURG OPEN DOOR INC/RS NPI 1104056969

NPI Information

NPI: 1104056969
Provider Name: MECKLENBURG OPEN DOOR, INC/RS
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
3501 E INDEPENDENCE BLVD
CHARLOTTE, NC
ZIP 28205
Phone: (704) 536-9159
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MECKLENBURG OPEN DOOR, INC/RS is a community based residential treatment facility mental illness in Charlotte, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MECKLENBURG OPEN DOOR, INC/RS NPI is 1104056969. The provider is registered as an organization entity type.

The provider's business location address is:

3501 E INDEPENDENCE BLVD
CHARLOTTE, NC
ZIP 28205-261
Phone: (704) 536-9159
Fax: (704) 537-6726

The provider's authorized official is Edward G Payton .
The authorized official title is Executive Director and has the following contact phone number (704) 525-3255.

The enumeration date for this NPI number is 7/15/2009 and was last updated on 7/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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