Provider Demographics
NPI:1891330056
Name:VERITAS COLLABORATIVE CHARLOTTE, LLC DBA THE EMILY PROGRAM
Entity type:Organization
Organization Name:VERITAS COLLABORATIVE CHARLOTTE, LLC DBA THE EMILY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSCHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-364-5977
Mailing Address - Street 1:1295 BANDANA BLVD.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108
Mailing Address - Country:US
Mailing Address - Phone:866-364-5977
Mailing Address - Fax:919-213-7003
Practice Address - Street 1:1900 SCOTT AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6046
Practice Address - Country:US
Practice Address - Phone:888-364-5977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty