Organization
CHARLOTTE MC LLC
Active
Other names
Northlake House
Organization subpart
No
Provider details
NPI number
Authorized official
JENNILEE M RICHARDSON (CFO)
(919) 621-2093
Entity
Organization
Contact information
Practice address
9108 REAMES RD, CHARLOTTE, NC 28216-1824
(980) 655-2032
Mailing address
5430 WADE PARK BLVD STE 310, RALEIGH, NC 27607-4191
(919) 371-4233
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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