Provider Demographics
NPI:1992985683
Name:M & B COMMUNITY SERVICES
Entity type:Organization
Organization Name:M & B COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:BSBA
Authorized Official - Phone:704-734-5847
Mailing Address - Street 1:906 BROOKLEE DR
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-4155
Mailing Address - Country:US
Mailing Address - Phone:704-734-5847
Mailing Address - Fax:
Practice Address - Street 1:602 SLATER ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3149
Practice Address - Country:US
Practice Address - Phone:704-678-2165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health