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Organization
MCCLAIN'S FAMILY CARE HOME #1
Active
Organization
MCCLAIN'S FAMILY CARE HOME #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK OLDPA MCCLAIN PATRICK MCCLAIN (OWNER/ADMINISTRATOR)
(704) 713-9920
Entity
Organization
Contact information
Practice address
5953 THE PLAZA, CHARLOTTE, NC 28215-2451
(980) 207-4747
Mailing address
5953 THE PLAZA, CHARLOTTE, NC 28215-2451
(980) 207-4747
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
FCL-060-123
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FCL-060-123
—
NC
Enumeration date
06/20/2012
Last updated
08/10/2012
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