St. Michael'S Therapeutic Services, Inc

Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Spencer, NC

NPI 1992833271 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1992833271
Entity type
Organization (NPI type 2)
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
License
MHL-080-120 (NC)
Legal business name
ST. MICHAEL'S THERAPEUTIC SERVICES, INC
Practice address
708 S Rowan Ave
Spencer, NC 28159-2146
Phone
(704) 637-3375
Fax
(704) 637-3375
NPI assigned
Mar 1, 2007
Organization subpart
No

Authorized official

Name
Ms. Tasheema Yvette Shore, BS.QP
Title
Owner
Phone
(704) 701-2582

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
St Michael'S Therapeutic Services Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-080-120 NC Yes

Addresses

Primary practice location

708 S Rowan Ave
Spencer, NC 28159-2146

Mailing address

708 S Rowan Ave
Spencer, NC 28159-2146
Phone (704) 637-3375

Other providers in Spencer, NC

All providers in Spencer, NC · Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.