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NPI Code Detail

MEDICARE: BREADWINNERS MANAGEMENT SOLUTIONS LLC

MEDICARE: BREADWINNERS MANAGEMENT SOLUTIONS 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
1251C00000XDevelopmentally Disabled Services Day Training Agency
2253Z00000XIn Home Supportive Care Agency
3320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1699610022
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREADWINNERS MANAGEMENT SOLUTIONS LLC
Provider Business Mailing Address
First Line : 5330 CAMBRIDGE BAY DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-6115
Country : US
Telephone Number : 704-421-0730
Fax Number :
Provider Business Practice Location Address
First Line : 5330 CAMBRIDGE BAY DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-6115
Country : US
Telephone Number : 704-421-0730
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : JESSICA GILBERT HICKS
Credential : MHRD, SPHR
Telephone Number : 704-421-0730
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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Directions to “BREADWINNERS MANAGEMENT SOLUTIONS LLC ” Practice Location

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