OrganizationActive
Conversion Therapeutic Services Inc
NPI 1295598704 · Developmental Disabilities Clinic/Center · Charlotte, NC
Provider details
- NPI number
- 1295598704
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Tenicia Washington, Owner
Practice location
11535 Carmel Commons Blvd Ste 102
Charlotte, NC 28226-5314
Phone: (704) 910-1788
Mailing address
848 Kathy Dianne Dr
Indian Land, SC 29707-6898
Registry dates
- Enumerated
- 2024-02-06
- Last updated
- 2024-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.