Healthcare Provider Details

I. General information

NPI: 1215780648
Provider Name (Legal Business Name): KONNECTS KARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 EXECUTIVE CENTER DR STE 228
CHARLOTTE NC
28212-8821
US

IV. Provider business mailing address

5500 EXECUTIVE CENTER DR STE 228
CHARLOTTE NC
28212-8821
US

V. Phone/Fax

Practice location:
  • Phone: 704-307-7590
  • Fax:
Mailing address:
  • Phone: 704-307-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY N WALKER
Title or Position: CEO/OWNER
Credential:
Phone: 704-307-7590