Provider Demographics
NPI:1346338233
Name:UNITED TREATMENT FACILITY, INC
Entity Type:Organization
Organization Name:UNITED TREATMENT FACILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:BS QMHP
Authorized Official - Phone:704-466-0046
Mailing Address - Street 1:PO BOX 9329
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28299-9329
Mailing Address - Country:US
Mailing Address - Phone:704-466-0046
Mailing Address - Fax:704-569-7912
Practice Address - Street 1:5004 COMMUNITY CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-1550
Practice Address - Country:US
Practice Address - Phone:704-569-9192
Practice Address - Fax:704-569-7912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC060595322D00000X
NC060844322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMHL 060 696OtherNC LICENSE
NCMHL 060 1012OtherNC LICENSE
NCMHL 060 844OtherNC LICENSE
NCMHL 060 595OtherNC LICENSE