GENESIS PROJECT 1
Managed Care Organizations at Reagan Dr, Charlotte, NC

License number
North Carolina P009049
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: DR. TRASHA BLACK PHD
Title: CLINICAL DIRECTOR
Phone: (704) 596-0505
Address
Address
5108 Reagan Dr SUITE 14, Charlotte, NC 28206
National Provider ID: 1417364480
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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