CAROLINA OUTREACH NPI 1407585706

NPI Information

NPI: 1407585706
Provider Name: CAROLINA OUTREACH
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
5108 REAGAN DR
CHARLOTTE, NC
ZIP 28206
Phone: (704) 332-8787
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CAROLINA OUTREACH is a mental health (including community mental health center) clinic center in Charlotte, NC. CAROLINA OUTREACH NPI is 1407585706. The provider is registered as an organization entity type.

The provider's business location address is:

5108 REAGAN DR
CHARLOTTE, NC
ZIP 28206-103
Phone: (704) 332-8787

The provider's authorized official is Jeremy Fitzgerald .
The authorized official title is Intensive In-home Therapist and has the following contact phone number (704) 565-9538.

The enumeration date for this NPI number is 6/10/2022 and was last updated on 6/10/2022.

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	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			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: 11/14/2023

NPI Synchronization or Removal

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