Organization
AUTUMN CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D GREENE BA, QP, CDS (OWNER)
(980) 335-1222
Entity
Organization
Contact information
Practice address
1545 PEACHTREE RD, CHARLOTTE, NC 28216-1607
(980) 208-4647
Mailing address
121 GREENWICH RD STE 205, CHARLOTTE, NC 28211-2365
(980) 335-1222
(980) 237-9266
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
04/30/2020
Last updated
12/02/2024
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