Provider Demographics
NPI:1568602746
Name:VIRTUE, INC.
Entity Type:Organization
Organization Name:VIRTUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LA'SHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-568-1490
Mailing Address - Street 1:PO BOX 35492
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28235-5492
Mailing Address - Country:US
Mailing Address - Phone:704-568-1490
Mailing Address - Fax:
Practice Address - Street 1:3387 E HIGHWAY 150
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-8144
Practice Address - Country:US
Practice Address - Phone:704-568-1490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No251S00000XAgenciesCommunity/Behavioral Health