Provider Demographics
NPI:1043677727
Name:CONCEPTS OF INDEPENDENCE LLC.
Entity type:Organization
Organization Name:CONCEPTS OF INDEPENDENCE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINETTE
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:917-547-3764
Mailing Address - Street 1:P.O. BOX 5084
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027
Mailing Address - Country:US
Mailing Address - Phone:704-274-3199
Mailing Address - Fax:704-270-3198
Practice Address - Street 1:530 E. FISHER STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-274-3199
Practice Address - Fax:704-270-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children