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Organization
CONNECTED CREW
Active
Organization
CONNECTED CREW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAQUANDRA JEFFERIES (OWNER)
(980) 420-0626
Entity
Organization
Contact information
Practice address
7918 BRISTLE LN, CHARLOTTE, NC 28214-8409
(980) 420-0626
Mailing address
7918 BRISTLE LN, CHARLOTTE, NC 28214-8409
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
NULL
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NULL
310500000X
Mental Illness Intermediate Care Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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