Healthcare Provider Details

I. General information

NPI: 1356408082
Provider Name (Legal Business Name): ABOUND HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 IDLEWILD RD N
MINT HILL NC
28227-3962
US

IV. Provider business mailing address

3330 MONROE RD STE A
CHARLOTTE NC
28205-7734
US

V. Phone/Fax

Practice location:
  • Phone: 704-321-1635
  • Fax:
Mailing address:
  • Phone: 704-536-8888
  • Fax: 980-256-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3408797
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: DEVON R CORNETT
Title or Position: VICE PRESIDENT OF NETWORK SUPPORT
Credential:
Phone: 704-916-6656