Provider Demographics
NPI:1437782935
Name:BEHAVIORAL HEALTH SOLUTION OF THE CAROLINAS LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH SOLUTION OF THE CAROLINAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-586-6918
Mailing Address - Street 1:1565 EBENEZER RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2494
Mailing Address - Country:US
Mailing Address - Phone:803-504-1747
Mailing Address - Fax:
Practice Address - Street 1:9711 DAVID TAYLOR DR APT 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2370
Practice Address - Country:US
Practice Address - Phone:980-949-6846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty