Healthcare Provider Details

I. General information

NPI: 1598581035
Provider Name (Legal Business Name): HEARTLAND ADULT DAY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4917 SOUTH BLVD
CHARLOTTE NC
28217-2166
US

IV. Provider business mailing address

4917 SOUTH BLVD
CHARLOTTE NC
28217-2166
US

V. Phone/Fax

Practice location:
  • Phone: 704-999-6797
  • Fax: 704-931-5246
Mailing address:
  • Phone: 704-999-6797
  • Fax: 704-931-5246

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: NIGATU NEGEYA KASSA
Title or Position: PRESIDENT
Credential:
Phone: 704-999-6797