MISS Peggy Green
NPI #1174826390 in Charlotte, North Carolina
Provider Information
- NPI Number
- 1174826390
- Entity Type
- Individual
- Name
- MISS Peggy Green
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Dec 9, 2010
- Last Updated
- Dec 9, 2010
Practice Location
- Address
- 6400 IVORY PALM DR
- City
- Charlotte
- State
- North Carolina
- ZIP Code
- 28227-2435
- Phone
- (704) 910-5458
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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