| Organization Name: | MECKLENBURG OPEN DOOR, INC. |
| NPI Number: | 1306076161 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWARD G PAYTON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1515 Mockingbird Ln Suite 1015 Charlotte |
| State: | NC US |
| Postal Code: | 282093236 |
| Phone Number: | 7045253255 |
| Fax Number: | 7045250949 |
| NPI Enumeration Date: | 07/15/2009 |
| NPI Last Update Date: | 07/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320800000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |