# CHARLOTTE MC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northlake House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417759028
- **Authorized official:** JENNILEE M RICHARDSON (CFO)
- **Authorized official phone:** (919) 621-2093

## Contact information

- **Practice address:** 9108 REAMES RD, CHARLOTTE, NC 28216-1824
- **Practice address phone:** (980) 655-2032
- **Mailing address:** 5430 WADE PARK BLVD STE 310, RALEIGH, NC 27607-4191
- **Mailing address phone:** (919) 371-4233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/25/2025
- **Last updated:** 03/25/2025