Healthcare Provider Details

I. General information

NPI: 1316678584
Provider Name (Legal Business Name): SOLID GROUNDS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 09/04/2023
Certification Date: 09/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7714 PONDEROSA PINE LN
CHARLOTTE NC
28215-4476
US

IV. Provider business mailing address

7714 PONDEROSA PINE LN
CHARLOTTE NC
28215-4476
US

V. Phone/Fax

Practice location:
  • Phone: 704-777-2398
  • Fax:
Mailing address:
  • Phone: 704-777-2398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care 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: SHALANDES HARRIS
Title or Position: OWNER
Credential:
Phone: 704-777-2398