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Organization
INNOVATIVE HOME HEALTH AGENCY
Active
Organization
INNOVATIVE HOME HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY GORDON (OWNER)
(980) 287-6420
Entity
Organization
Contact information
Practice address
101 N TRYON ST, CHARLOTTE, NC 28246-0100
(980) 287-6420
Mailing address
11719 ALLEN A BROWN RD, CHARLOTTE, NC 28269-8412
(980) 287-6420
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
NULL
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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