Provider Demographics
NPI:1972176915
Name:NORTH CHARLOTTE NC CAREGIVING LLC
Entity type:Organization
Organization Name:NORTH CHARLOTTE NC CAREGIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-400-2625
Mailing Address - Street 1:20462 CHARTWELL CENTER DR STE D
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6596
Mailing Address - Country:US
Mailing Address - Phone:704-387-5040
Mailing Address - Fax:
Practice Address - Street 1:20462 CHARTWELL CENTER DR STE D
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6596
Practice Address - Country:US
Practice Address - Phone:704-387-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE CAREGIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care