Healthcare Provider Details

I. General information

NPI: 1790511327
Provider Name (Legal Business Name): JUST IN TIME HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 MONROE RD STE 108G
CHARLOTTE NC
28205-7533
US

IV. Provider business mailing address

3010 MONROE RD STE 108G
CHARLOTTE NC
28205-7533
US

V. Phone/Fax

Practice location:
  • Phone: 980-777-3980
  • Fax: 980-207-0332
Mailing address:
  • Phone: 980-777-3980
  • Fax: 980-207-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RAVEN BRODEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 980-777-3980