NPI 1063569127

Bertha's Place, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Charlotte, NC

Practice location

Address: 3412 Green Meadow Dr., Charlotte, NC 28269-2982
Phone: (704) 598-5106
Fax: (704) 598-5106
Mailing address: 2424 Logan Field Dr., Waxhaw, NC 28173-6962

Authorised official

Name: Wayne Louis Garris
Title: Executive Director
Phone: (704) 598-5106

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence MHL060-871 (NC)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in North Carolina →

Registry record

NPI: 1063569127
Entity type: Organization
NPI issued: 4 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.