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1245094192
CONVERSION THERAPEUTIC SERVICES INC
CHARLOTTE, NC
NPI
1245094192
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Entity Type
Organization
Authorized Contact
TENICIA WASHINGTON
Owner
443-531-1988
Organization Subpart ?
No
Primary Taxonomy
261QM1300X Clinic/Center, Multi-Specialty
Enumeration Date
2024-02-12
Last Update Date
2024-10-08
Business Address
CONVERSION THERAPEUTIC SERVICES INC
11535 CARMEL COMMONS BLVD STE 102
CHARLOTTE, NC 28226-5314
Phone number: 704-910-1788
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Mailing Address
CONVERSION THERAPEUTIC SERVICES INC
848 KATHY DIANNE DR
INDIAN LAND, SC 29707-6898
Phone number: 443-531-1988
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