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Miss Peggy Green
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Charlotte, North Carolina
NPI 1174826390

Peggy Green is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Charlotte, NC. Peggy Green practices in Charlotte, NC. The NPI Number for Peggy Green is 1174826390 and holds a License No. (North Carolina).

The current practice location address for Peggy Green is 6400 Ivory Palm Dr, Charlotte, NC and can be reached out via phone at 704-910-5458.

Location: 6400 Ivory Palm Dr, Charlotte, NC, 28227-2435
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174826390
Provider Name
Peggy Green
Credential
Provider Entity Type
Individual
Gender
Female
Address
6400 Ivory Palm Dr, Charlotte, NC, 28227-2435
Phone Number
704-910-5458
Fax Number
Provider Enumeration Date
12/09/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6400 Ivory Palm Dr
City
Charlotte
State
North Carolina
Zip
28227-2435
Phone Number
704-910-5458
Fax Number
person
Provider Business Mailing Address Details
Address
6400 Ivory Palm Dr
City
Charlotte
State
North Carolina
Zip
28227-2435
Phone Number
704-910-5458
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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