Provider Demographics
NPI:1619029501
Name:METROLINA AIDS PROJECT
Entity Type:Organization
Organization Name:METROLINA AIDS PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-333-1435
Mailing Address - Street 1:PO BOX 32662
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28232-2662
Mailing Address - Country:US
Mailing Address - Phone:704-333-1435
Mailing Address - Fax:704-602-2440
Practice Address - Street 1:127 SCALEYBARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2608
Practice Address - Country:US
Practice Address - Phone:704-333-1435
Practice Address - Fax:704-602-2440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005870Medicaid