Organization
DECREE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE DUGGER (DIRECTOR)
(336) 701-2551
Entity
Organization
Contact information
Practice address
609 S MAIN ST, KANNAPOLIS, NC 28081-4913
(336) 701-2551
Mailing address
1820 HARRIS HOUSTON ROAD, UNIT 620024, CHARLOTTE, NC 28262
(336) 701-2551
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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