Healthcare Provider Details

I. General information

NPI: 1427891605
Provider Name (Legal Business Name): ZEN HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 SUMMERTIME DR APT 2601
CHARLOTTE NC
28262-5626
US

IV. Provider business mailing address

7014 SMITH CORNERS BLVD # 1151
CHARLOTTE NC
28269-3793
US

V. Phone/Fax

Practice location:
  • Phone: 704-712-8161
  • Fax:
Mailing address:
  • Phone: 704-712-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROMUALD KOLIKO
Title or Position: OWNER
Credential:
Phone: 704-712-8161