Provider Demographics
NPI:1770940256
Name:MELANGE SOLUTIONS LLC
Entity type:Organization
Organization Name:MELANGE SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:THAGGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-537-3650
Mailing Address - Street 1:PO BOX 42973
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-0037
Mailing Address - Country:US
Mailing Address - Phone:704-537-3650
Mailing Address - Fax:866-909-5364
Practice Address - Street 1:454 ANDERSON RD S
Practice Address - Street 2:BTC541
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3392
Practice Address - Country:US
Practice Address - Phone:704-537-3650
Practice Address - Fax:866-909-5364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty