Organization
NORTHLAKE AL HOLDINGS, LLC
Active
Other names
Northlake House
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E TREFZGER (MANAGER)
(828) 322-5535
Entity
Organization
Contact information
Practice address
9108 REAMES RD, CHARLOTTE, NC 28216-1824
(980) 859-6000
Mailing address
PO BOX 2568, HICKORY, NC 28603-2568
(828) 322-5535
(828) 326-8115
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
HAL060150
NC
311ZA0620X
Adult Care Home Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
10/27/2016
Last updated
11/02/2021
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