Organization
HERITAGE HOMECARE OF GASTONIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RICO AKIVA WAGNER (OWNER)
(704) 763-2168
Entity
Organization
Contact information
Practice address
1913 J N PEASE PL STE 103, CHARLOTTE, NC 28262-4537
(704) 763-7168
Mailing address
1913 J N PEASE PL STE 103, CHARLOTTE, NC 28262-4537
(704) 763-7168
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
10/04/2023
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