MEDICARE: GIFTED LIVING HOME SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	315P00000X	Intellectual Disabilities Intermediate Care Facility
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
3	320800000X	Mental Illness Community Based Residential Treatment Facility
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1770417149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFTED LIVING HOME SERVICES

Provider Business Mailing Address
First Line	:	3913 BEARWOOD AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-1329
Country	:	US
Telephone Number	:	704-713-8361
Fax Number	:	704-270-9309

Provider Business Practice Location Address
First Line	:	3913 BEARWOOD AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-1329
Country	:	US
Telephone Number	:	704-713-8361
Fax Number	:	704-270-9309

Authorized Official
Title or Position	:	CEO
Name	:	MR. VINCENT BRYANT ABLE JR.
Credential	:
Telephone Number	:	704-713-8361

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “GIFTED LIVING HOME SERVICES ” Practice Location

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