Healthcare Provider Details
I. General information
NPI: 1639907793
Provider Name (Legal Business Name): BUOYANT HEALTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12910 BELVEDERE CASTLE DR
CHARLOTTE NC
28273-7272
US
IV. Provider business mailing address
12910 BELVEDERE CASTLE DR
CHARLOTTE NC
28273-7272
US
V. Phone/Fax
- Phone: 470-753-1084
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
JANGA
ANTHONY
Title or Position: CEO
Credential:
Phone: 470-753-1084