Provider Demographics
NPI:1497410526
Name:OPENDORS,LLC.
Entity Type:Organization
Organization Name:OPENDORS,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORESSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKETHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-797-7490
Mailing Address - Street 1:301 S MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2623
Mailing Address - Country:US
Mailing Address - Phone:980-890-8904
Mailing Address - Fax:
Practice Address - Street 1:715 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5666
Practice Address - Country:US
Practice Address - Phone:980-890-8904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness