Provider Demographics
NPI:1134876824
Name:VINTAGE SOLUTIONS LLC
Entity type:Organization
Organization Name:VINTAGE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:QDDP
Authorized Official - Phone:980-253-5487
Mailing Address - Street 1:7114 LENTON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-0301
Mailing Address - Country:US
Mailing Address - Phone:980-253-5487
Mailing Address - Fax:
Practice Address - Street 1:7114 LENTON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-0301
Practice Address - Country:US
Practice Address - Phone:980-253-5487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health