MEDICARE: UNCLE NUNK NUNK'S LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1366396657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNCLE NUNK NUNK'S LLC

Provider Business Mailing Address
First Line	:	4405 TILLMAN RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-2111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 TILLMAN RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-2111
Country	:	US
Telephone Number	:	706-412-1410
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ZECHARIAH EZEKIEL THOMAS
Credential	:	THOMAS
Telephone Number	:	706-412-1410

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

Similar Medicare Providers

1285439125 — UNCLE NUNK NUNK'S LLC
Practice Location Address:

4405 TILLMAN RD
CHARLOTTE, NC
28208-2111

Practice Phone: 706-412-1410
Practice Fax:

1952259343 — CM COUNSELING, PLLC
Practice Location Address:

5970 FAIRVIEW RD STE 600
CHARLOTTE, NC
28210-2111

Practice Phone: 704-242-3222
Practice Fax:

1205138187 — ENVISION IT COUNSELING AND COACHING SERVICES
Practice Location Address:

329 FRANK DR
CHARLOTTE, NC
28215-2111

Practice Phone: 704-631-6818
Practice Fax:

1164700548 — HEIDI CAMPBELL CD(DONA), MBA, CMR
Practice Location Address:

3343 EASTWOOD DR
CHARLOTTE, NC
28205-2111

Practice Phone: 704-226-5443
Practice Fax:

1427493386 — JGSJ LLC
Practice Location Address:

3437 PONDRIDGE CT
CHARLOTTE, NC
28269-2111

Practice Phone: 704-458-3020
Practice Fax:

1609261957 — OPTIMUM OF NORTH CAROLINA INC
Practice Location Address:

3437 PONDRIDGE CT
CHARLOTTE, NC
28269-2111

Practice Phone: 704-975-2484
Practice Fax:

Directions to “UNCLE NUNK NUNK'S LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.