Provider Demographics
NPI:1275168775
Name:CEDAR TREE EMPOWERMENT CENTER LLC
Entity Type:Organization
Organization Name:CEDAR TREE EMPOWERMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER/ CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-580-1222
Mailing Address - Street 1:8033 MCCARRON WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8033 MCCARRON WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-8713
Practice Address - Country:US
Practice Address - Phone:704-284-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty