Organization · NPI-2

Advanced Community Services LLC

Social Worker, Clinical · Charlotte, NC

NPI number1558860239
StatusActive
Last updated in NPPESApr 20, 2018

Details

NPI
1558860239
Entity type
Organization (NPI-2)
Legal business name
Advanced Community Services LLC
Organization subpart
No
Enumeration date
Feb 7, 2018
Last updated
Apr 20, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical–NCYes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)–NC
261QM0850X Clinic/Center, Adult Mental Health–NC

Practice location

4700 Farm Pond Ln
Charlotte, NC 28212-8500

Phone 704-241-1643

Mailing address

3984 Landmark Dr
Douglasville, GA 30135-1254

Phone 704-241-1643

Authorized official

Kimberly Penny
Executive Director
7042411643

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