Provider Demographics
NPI:1578835096
Name:MELANGE HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MELANGE HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-567-8690
Mailing Address - Street 1:PO BOX 29234
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28229-9234
Mailing Address - Country:US
Mailing Address - Phone:704-567-8690
Mailing Address - Fax:704-536-6030
Practice Address - Street 1:931 WILANN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-2147
Practice Address - Country:US
Practice Address - Phone:704-567-8690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health