OrganizationActive
Bertha'S Place, Inc.
NPI 1063569127 · Emotionally Disturbed Childrens' Residential Treatment Facility · Charlotte, NC
Provider details
- NPI number
- 1063569127
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Wayne Garris, Executive Director(704) 598-5106
- License
- MHL060-871 (NC)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense MHL060-871 (NC)
Residential Treatment Facilities
Practice location
3412 Green Meadow Dr.
Charlotte, NC 28269-2982
Phone: (704) 598-5106
Fax: (704) 598-5106
Approximate (ZIP-level) locationGet directions
Mailing address
2424 Logan Field Dr.
Waxhaw, NC 28173-6962
Registry dates
- Enumerated
- 2007-01-04
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.