Provider Demographics
NPI:1912777855
Name:CHARDEVELOP LLC
Entity Type:Organization
Organization Name:CHARDEVELOP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVERITTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:609-816-4459
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:NC
Mailing Address - Zip Code:27342-0141
Mailing Address - Country:US
Mailing Address - Phone:609-816-4459
Mailing Address - Fax:
Practice Address - Street 1:6903 KEENELAND DR
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9842
Practice Address - Country:US
Practice Address - Phone:609-816-4459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty