LATESHA GREEN

CHARLOTTE, NC
NPI1972239127
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Additional Taxonomies261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date2022-07-29
Last Update Date2022-07-29
Business Address
LATESHA GREEN
3409 DOMINION GREEN DR
CHARLOTTE, NC 28269-7932
Phone number: 704-906-4522
Mailing Address
LATESHA GREEN
3409 DOMINION GREEN DR
CHARLOTTE, NC 28269-7932
Phone number: 704-906-4522