Provider Demographics
NPI:1598544355
Name:CASTING DOWN STRONGHOLDS TRANSITIONAL HOUSING & COMMUNITY SERVICES
Entity type:Organization
Organization Name:CASTING DOWN STRONGHOLDS TRANSITIONAL HOUSING & COMMUNITY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERNELL
Authorized Official - Middle Name:TAMIKA
Authorized Official - Last Name:MACKIE
Authorized Official - Suffix:
Authorized Official - Credentials:CART,CPLC,CDVS,CCTS
Authorized Official - Phone:704-605-3382
Mailing Address - Street 1:5765 CEDARS EAST CT APT 2
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-0171
Mailing Address - Country:US
Mailing Address - Phone:704-605-3382
Mailing Address - Fax:
Practice Address - Street 1:8539 MONROE RD STE 105
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-7510
Practice Address - Country:US
Practice Address - Phone:704-605-3382
Practice Address - Fax:888-453-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty