Provider Demographics
NPI:1871372359
Name:SUPPORTIVE HOUSING COMMUNITIES
Entity type:Organization
Organization Name:SUPPORTIVE HOUSING COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-587-3237
Mailing Address - Street 1:601 E 5TH ST STE 255
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3010
Mailing Address - Country:US
Mailing Address - Phone:980-505-6358
Mailing Address - Fax:
Practice Address - Street 1:2120 N DAVIDSON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-1828
Practice Address - Country:US
Practice Address - Phone:980-505-6358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health