Healthcare Provider Details

I. General information

NPI: 1376339960
Provider Name (Legal Business Name): NIA PROPERTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 LEBANON RD STE A3
MINT HILL NC
28227-8265
US

IV. Provider business mailing address

PO BOX 690670
CHARLOTTE NC
28227-7012
US

V. Phone/Fax

Practice location:
  • Phone: 704-957-4722
  • Fax: 704-706-2629
Mailing address:
  • Phone: 704-957-4722
  • Fax: 704-706-2629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: HARRY EDDIE SEYMOUR
Title or Position: PRESIDENT
Credential:
Phone: 704-957-4722