Provider Demographics
NPI:1255177143
Name:CP COALITION LLC
Entity type:Organization
Organization Name:CP COALITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TCM SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:VENUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS MSW LCASA CMC
Authorized Official - Phone:704-231-2859
Mailing Address - Street 1:8511 DAVIS LAKE PKWY STE C6-234
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0536
Mailing Address - Country:US
Mailing Address - Phone:704-231-2859
Mailing Address - Fax:704-672-5234
Practice Address - Street 1:8511 DAVIS LAKE PKWY STE C6-234
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0536
Practice Address - Country:US
Practice Address - Phone:704-231-2859
Practice Address - Fax:704-672-5234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty