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Organization
NO PLACEMENT LIKE HOME
Active
Organization
NO PLACEMENT LIKE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUAL SOUVENIR LPN (CEO)
(704) 835-2291
Entity
Organization
Contact information
Practice address
3016 COLONY RD, CHARLOTTE, NC 28211-3239
(704) 835-2291
(704) 835-2291
Mailing address
6211 CARMEL RD STE 204, CHARLOTTE, NC 28226-8258
(704) 835-2291
(704) 831-9091
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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