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Tina Wilson
Mental Illness Community Based Residential Treatment Facility in Mt Holly, North Carolina
NPI 1033653720

Tina Wilson is a Mental Illness Community Based Residential Treatment Facility based in Mt Holly, NC. Tina Wilson practices in Mt Holly, NC. The NPI Number for Tina Wilson is 1033653720 and holds a License No. MHL-036-323 (North Carolina).

The current practice location address for Tina Wilson is 139 Whippoorwill Ln, Mt Holly, NC and can be reached out via phone at 704-574-1549.

Location: 139 Whippoorwill Ln, Mt Holly, NC, 28120-9761
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033653720
Provider Name
Tina Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
139 Whippoorwill Ln, Mt Holly, NC, 28120-9761
Phone Number
704-574-1549
Fax Number
Provider Enumeration Date
12/14/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
139 Whippoorwill Ln
City
Mt Holly
State
North Carolina
Zip
28120-9761
Phone Number
704-574-1549
Fax Number
person
Provider Business Mailing Address Details
Address
139 Whippoorwill Ln
City
Mt Holly
State
North Carolina
Zip
28120-9761
Phone Number
704-574-1549
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
MHL-036-323 (North Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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