Promise Resource Network, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROMISE RESOURCE NETWORK, INC

Practice address

1041 Hawthorne LN
Charlotte, NC 28205-2915

Phone

(980) 321-4021

NPI assigned

Jan 19, 2014

Last updated

Jan 19, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Cherene Marie Allen-Caraco, BA, QMHP, QDDP, CESP

Title

Executive Director

Phone

(704) 776-6707

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mecklenburg's PROMISE, Inc Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390089600000",
    "number": "1639591084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052915",
            "telephone_number": "980-321-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052915",
            "telephone_number": "980-321-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE RESOURCE NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-19",
        "last_updated": "2014-01-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN-CARACO",
        "authorized_official_first_name": "CHERENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-776-6707",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA, QMHP, QDDP, CESP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mecklenburg's PROMISE, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.