Healthcare Provider Details

I. General information

NPI: 1164360806
Provider Name (Legal Business Name): CHRISTOPHER MATTHEW ROMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9207 TENBY LN
MATTHEWS NC
28104-3003
US

IV. Provider business mailing address

9207 TENBY LN
MATTHEWS NC
28104-3003
US

V. Phone/Fax

Practice location:
  • Phone: 704-777-9140
  • Fax:
Mailing address:
  • Phone: 704-777-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberMHL-090-228
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: