Organization
EDUCARE COMMUNITY LIVING CORPORATION - NORTH CAROLINA
Active
Other names
EC Char Leaves
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (PROVIDER ENROLLMENT MGR)
(502) 381-3579
Entity
Organization
Contact information
Practice address
7106 LEAVES LN, CHARLOTTE, NC 28213-5748
(704) 598-9932
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340609J
—
NC
Enumeration date
03/30/2007
Last updated
06/01/2021
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