Provider Demographics
NPI:1972944759
Name:INTRUSTED CARE SOLUTIONS INC
Entity Type:Organization
Organization Name:INTRUSTED CARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-492-6954
Mailing Address - Street 1:2340 N GRAHAM ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2506
Mailing Address - Country:US
Mailing Address - Phone:980-213-6095
Mailing Address - Fax:
Practice Address - Street 1:2340 N GRAHAM ST STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2506
Practice Address - Country:US
Practice Address - Phone:980-213-6095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty