Healthcare Provider Details

I. General information

NPI: 1689344533
Provider Name (Legal Business Name): WILLIAM HAYWARD KING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W ARGYLE DR
CHARLOTTE NC
28213-6171
US

IV. Provider business mailing address

4410 W ARGYLE DR
CHARLOTTE NC
28213-6171
US

V. Phone/Fax

Practice location:
  • Phone: 704-900-7744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM HAYWARD KING
Title or Position: OWNER
Credential:
Phone: 704-900-7744