MEDICARE: ENSTART & ASSOCIATES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548641194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENSTART & ASSOCIATES

Provider Business Mailing Address
First Line	:	12524 HAMMERSMITH CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-0433
Country	:	US
Telephone Number	:	704-464-6158
Fax Number	:

Provider Business Practice Location Address
First Line	:	12524 HAMMERSMITH CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-0433
Country	:	US
Telephone Number	:	704-464-6158
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MRS. HARRIET WHITTED JACKSON
Credential	:	JD
Telephone Number	:	704-464-6158

Provider Enumeration Date	:	06/09/2015
Last Update Date	:	06/09/2015

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Directions to “ENSTART & ASSOCIATES ” Practice Location

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