| Footprints Carolina Inc | |
|
917 First Street Shelby NC 28150-3958 | |
| (704) 480-6641 | |
| (704) 480-1364 |
| Full Name | Footprints Carolina Inc |
|---|---|
| Speciality | Case Management |
| Location | 917 First Street, Shelby, North Carolina |
| Authorized Official Name and Position | Richard Anderson (CEO) |
| Authorized Official Contact | 7048842500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Footprints Carolina Inc 2020 Remount Rd Gastonia NC 28054-7476 Ph: (704) 884-2500 | Footprints Carolina Inc 917 First Street Shelby NC 28150-3958 Ph: (704) 480-6641 |
| NPI Number | 1376725366 |
|---|---|
| Provider Enumeration Date | 11/30/2007 |
| Last Update Date | 12/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376725366 | NPI | - | NPPES |
| 6005633 | Medicaid | NC | |
| 5906002 | Medicaid | NC | |
| 8300451 | Medicaid | NC | |
| 8300451B | Medicaid | NC | |
| 8300451G | Medicaid | NC | |
| 8300451H | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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