Organization
CLEAN HANDS PURE HEART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERA TAHMARA DIGGS BROWN (OWNER)
(980) 865-8693
Entity
Organization
Contact information
Practice address
4724 GRASSET AVE, CHARLOTTE, NC 28269-4025
(980) 875-8693
Mailing address
4724 GRASSET AVE, CHARLOTTE, NC 28269-4025
(980) 875-8693
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3892146
DRIVERS LICENSE
NC
Enumeration date
04/30/2020
Last updated
09/12/2020
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