Provider Demographics
NPI:1760030134
Name:RELATIONSHIP ENRIHMENT CENTER
Entity Type:Organization
Organization Name:RELATIONSHIP ENRIHMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAITLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:704-560-4388
Mailing Address - Street 1:1136 SAM NEWELL RD STE D
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5064
Mailing Address - Country:US
Mailing Address - Phone:704-560-4388
Mailing Address - Fax:704-973-0161
Practice Address - Street 1:1136 SAM NEWELL RD STE D
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5064
Practice Address - Country:US
Practice Address - Phone:704-560-4388
Practice Address - Fax:704-973-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1154522100OtherLPCS