Provider Demographics
NPI:1568647782
Name:ST. FRANCIS OF CHARLOTTE INC.
Entity Type:Organization
Organization Name:ST. FRANCIS OF CHARLOTTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MHQP
Authorized Official - Phone:704-531-4402
Mailing Address - Street 1:3141 AMITY CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5745
Mailing Address - Country:US
Mailing Address - Phone:704-531-4402
Mailing Address - Fax:704-531-4405
Practice Address - Street 1:3141 AMITY CT
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-5745
Practice Address - Country:US
Practice Address - Phone:704-531-4402
Practice Address - Fax:704-531-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health