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Organization
APPOINTED TO PROVIDE HOME CARE AGENCY
Active
Organization
APPOINTED TO PROVIDE HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARRIKA A BURNETT (OWNER/PROVIDER)
(980) 219-3495
Entity
Organization
Contact information
Practice address
4817 SPRUCE PEAK RD, CHARLOTTE, NC 28278-6559
(980) 219-3495
Mailing address
4817 SPRUCE PEAK RD, CHARLOTTE, NC 28278-6559
(980) 219-3495
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372500000X
—
NC
05
—
372600000X
—
NC
05
—
373H00000X
—
NC
05
—
3747A0650X
—
NC
05
—
3747P1801X
—
NC
05
—
374J00000X
—
NC
05
—
374U00000X
—
NC
05
—
376J00000X
—
NC
05
—
376K00000X
—
NC
Enumeration date
01/20/2016
Last updated
01/20/2016
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