Provider Demographics
NPI:1841420981
Name:2ND II NONE FOUNDATION
Entity Type:Organization
Organization Name:2ND II NONE FOUNDATION
Other - Org Name:MATURING YOUNG MINDS CHILDREN AND FAMILY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-780-4608
Mailing Address - Street 1:PO BOX 481972
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5331
Mailing Address - Country:US
Mailing Address - Phone:704-780-4608
Mailing Address - Fax:704-780-1079
Practice Address - Street 1:5820 E WT HARRIS BLVD STE 111
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3604
Practice Address - Country:US
Practice Address - Phone:704-566-6134
Practice Address - Fax:705-566-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management