Bertha'S Place, Inc.

LBN: Bertha'S Place, Inc.
Bertha'S Place, Inc. is an health care organization with primary practice located at 3412 Green Meadow Dr. , Charlotte NC 28269-2982. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Bertha'S Place, Inc. can be contacted via phone (704) 598-5106, or through Garris, Wayne Louis via phone (704) 598-5106.

Contact Information

Primary practice address
3412 Green Meadow Dr. Charlotte NC 28269-2982
Phone: (704) 598-5106
Fax: (704) 598-5106
Website:
Map and Directions
Authorized official contact:
Name: Garris, Wayne Louis
Phone: (704) 598-5106

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL060-871 North Carolina

Profile Details

NPI number 1063569127
LBN Legal business name Bertha'S Place, Inc.
DBA Doing business as
Authorized official Garris, Wayne Louis
Entity Organization
Organization subpart 1 No
Enumeration date Jan 4th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063569127 NPPES
North Carolina MEDICAID 6603939

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