Individual provider · Type 1 NPI
Latesha Green
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Charlotte, NC
Practice location
3409 Dominion Green Dr
Charlotte, NC 28269-7932
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | None listed |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | None listed |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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About NPI 1972239127
Latesha Green's National Provider Identifier is 1972239127, issued on Jul 29, 2022. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Charlotte, NC. The record was last updated on Jul 29, 2022.