| New Leaf Adolescent Care, Inc | |
|
1945 J N Pease Pl Ste 102 Charlotte NC 28262-4555 | |
| (704) 405-8890 | |
| (704) 405-8893 |
| Full Name | New Leaf Adolescent Care, Inc |
|---|---|
| Speciality | Case Management |
| Location | 1945 J N Pease Pl Ste 102, Charlotte, North Carolina |
| Authorized Official Name and Position | Mickey Leon Rivers (CEO) |
| Authorized Official Contact | 7048915825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Adolescent Care, Inc 1945 J N Pease Pl Ste 102 Charlotte NC 28262-4555 Ph: (704) 405-8890 | New Leaf Adolescent Care, Inc 1945 J N Pease Pl Ste 102 Charlotte NC 28262-4555 Ph: (704) 405-8890 |
| NPI Number | 1821140401 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 12/04/2020 |
| Certification Date | 12/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821140401 | NPI | - | NPPES |
| 8301256B | Medicaid | NC | |
| 060-802 | Medicaid | NC |
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