Healthcare Provider Details

I. General information

NPI: 1184809774
Provider Name (Legal Business Name): SIMPLICITY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SIMPSON RD
CHARLOTTE NC
28216-5897
US

IV. Provider business mailing address

6701 SIMPSON RD
CHARLOTTE NC
28216-5897
US

V. Phone/Fax

Practice location:
  • Phone: 704-394-7006
  • Fax: 704-394-7892
Mailing address:
  • Phone: 704-394-7006
  • Fax: 704-394-7892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberMHL0601029
License Number StateNC

VIII. Authorized Official

Name: MRS. SHARKEETA S STEVENSON
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 704-394-7006