Healthcare Provider Details

I. General information

NPI: 1003452236
Provider Name (Legal Business Name): ART OF LIFE HOME CARE AND STAFFING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 E PRICE AVE STE 4
GASTONIA NC
28054-0471
US

IV. Provider business mailing address

619 E PRICE AVE STE 4
GASTONIA NC
28054-0471
US

V. Phone/Fax

Practice location:
  • Phone: 704-349-2184
  • Fax: 704-967-0269
Mailing address:
  • Phone: 704-349-2184
  • Fax: 704-967-0269

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JATAVIA STRICKLAND
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 704-349-2184