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BERTHA'S PLACE, INC.
NPI 1063569127
Residential Treatment Facility, Emotionally Disturbed Children in Charlotte, NC

Active since January 04, 2007
3412 GREEN MEADOW DR., CHARLOTTE, NC 28269(704) 598-5106(704) 598-5106 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bertha's Place, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERTHA'S PLACE, INC. (NPI 1063569127) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Charlotte, North Carolina and active in the NPI registry since January 2007. The organization lists Wayne Louis Garris, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1063569127
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameBERTHA'S PLACE, INC.
Location Address3412 GREEN MEADOW DR.Charlotte, NC 28269-2982
Mailing Address2424 Logan Field Dr.Waxhaw, NC 28173-6962 · (704) 243-4771 · Fax (704) 243-4771
Phone(704) 598-5106
Fax(704) 598-5106
Organization SubpartNo
Authorized OfficialWayne Louis GarrisExecutive Director · (704) 598-5106
Enumeration DateJanuary 4, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1063569127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
License✔ Licensed in NC · MHL060-871
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
3412 GREEN MEADOW DR., Charlotte, NC 28269
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Other Identifiers 1

Medicaid6603939NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bertha's Place, Inc.'s NPI number?

The NPI number for Bertha's Place, Inc. is 1063569127. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is Bertha's Place, Inc. located?

Bertha's Place, Inc. is located at 3412 Green Meadow Dr., Charlotte, NC 28269. The listed phone number is (704) 598-5106.

What is Bertha's Place, Inc.'s specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Bertha's Place, Inc. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.