Healthcare Provider Details

I. General information

NPI: 1841101268
Provider Name (Legal Business Name): AT HOME SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4346 TIPPERARY PL
CHARLOTTE NC
28215-3329
US

IV. Provider business mailing address

4346 TIPPERARY PL
CHARLOTTE NC
28215-3329
US

V. Phone/Fax

Practice location:
  • Phone: 704-619-2911
  • Fax:
Mailing address:
  • Phone: 704-619-2911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE DAVON BROWN
Title or Position: CEO
Credential: NP-C
Phone: 704-619-2911