Healthcare Provider Details

I. General information

NPI: 1487781886
Provider Name (Legal Business Name): A & S HOMEHEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 STATESVILLE RD
CHARLOTTE NC
28269-4248
US

IV. Provider business mailing address

4420 STATESVILLE RD
CHARLOTTE NC
28269-4248
US

V. Phone/Fax

Practice location:
  • Phone: 704-509-1197
  • Fax: 704-509-1198
Mailing address:
  • Phone: 704-509-1197
  • Fax: 704-509-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License NumberHC3407
License Number StateNC

VIII. Authorized Official

Name: MS. LAKESHIA B BARNES
Title or Position: OWNER
Credential:
Phone: 704-512-8694