Provider Demographics
NPI:1225231731
Name:NIAS PLACE INC.
Entity Type:Organization
Organization Name:NIAS PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BOYETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-649-0620
Mailing Address - Street 1:11834 SILVERCREST DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-9903
Mailing Address - Country:US
Mailing Address - Phone:704-649-0620
Mailing Address - Fax:
Practice Address - Street 1:11834 SILVERCREST DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-9903
Practice Address - Country:US
Practice Address - Phone:704-649-0620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management