Healthcare Provider Details

I. General information

NPI: 1538080361
Provider Name (Legal Business Name): HONORS GARDEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10205 PINESHADOW DR APT T102
CHARLOTTE NC
28262-1175
US

IV. Provider business mailing address

10205 PINESHADOW DR APT T102
CHARLOTTE NC
28262-1175
US

V. Phone/Fax

Practice location:
  • Phone: 980-307-3509
  • Fax:
Mailing address:
  • Phone: 980-307-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: KAMILAH HILL
Title or Position: OWNER
Credential:
Phone: 980-226-3357