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Organization
MALLARD CREEK LEARNING CENTER
Active
Organization
MALLARD CREEK LEARNING CENTER
Active
Parent organization
MALLARD CREEK LEARNING CENTER
Other names
Divine Health and Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
MALLARD CREEK LEARNING CENTER
Authorized official
MRS. JACQUELINE DENISE WILLIAMS (OWNER)
(704) 533-2870
Entity
Organization
Contact information
Practice address
8136 BROWNE RD, CHARLOTTE, NC 28269-1101
(704) 533-2870
(704) 948-2047
Mailing address
8136 BROWNE RD, CHARLOTTE, NC 28269-1101
(704) 533-2870
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
60002874
NC
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60002874
CHILD CARE LICENSE
NC
Enumeration date
06/06/2015
Last updated
06/06/2015
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