Provider Demographics
NPI:1174195705
Name:THE CARBON CENTER, LLC
Entity Type:Organization
Organization Name:THE CARBON CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCTP
Authorized Official - Phone:407-480-9469
Mailing Address - Street 1:5150 NW WHISPER ST
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8338
Mailing Address - Country:US
Mailing Address - Phone:407-480-9469
Mailing Address - Fax:
Practice Address - Street 1:5150 NW WHISPER ST
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8338
Practice Address - Country:US
Practice Address - Phone:407-480-9469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health