Provider Demographics
NPI:1992980387
Name:ABOUND HEALTH, LLC
Entity type:Organization
Organization Name:ABOUND HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF NETWORK SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-916-6656
Mailing Address - Street 1:3330 MONROE RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7734
Mailing Address - Country:US
Mailing Address - Phone:704-536-8888
Mailing Address - Fax:
Practice Address - Street 1:5309 IDLEWILD RD N
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-3962
Practice Address - Country:US
Practice Address - Phone:704-321-1635
Practice Address - Fax:704-321-1639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
NC251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408797Medicaid