Provider Demographics
NPI:1477864734
Name:THOMPSON CHILD AND FAMILY FOCUS
Entity Type:Organization
Organization Name:THOMPSON CHILD AND FAMILY FOCUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF IT
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-536-0375
Mailing Address - Street 1:6800 SAINT PETERS LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-8458
Mailing Address - Country:US
Mailing Address - Phone:704-536-0375
Mailing Address - Fax:704-531-9266
Practice Address - Street 1:769 N WENDOVER RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-376-7180
Practice Address - Fax:704-376-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00000000Medicaid