Provider Demographics
NPI:1336727700
Name:LAUNCH HEALTH SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:LAUNCH HEALTH SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-999-9620
Mailing Address - Street 1:8115 SOLACE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3214
Mailing Address - Country:US
Mailing Address - Phone:704-999-9620
Mailing Address - Fax:888-617-8144
Practice Address - Street 1:715 E 5TH ST STE 214
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3001
Practice Address - Country:US
Practice Address - Phone:707-231-3191
Practice Address - Fax:888-617-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1126196708111970Medicaid