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General NPI Number Information
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NPI Number | 1801402425
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Entity Type | Organization
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Legal Business Name | NEW KYDZ OF HOPE LLC
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 9635 SOUTHERN PINE BLVD STE 102
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City | CHARLOTTE
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State | NC
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Zip | 28273-5546
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Country | US
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Telephone | 704-780-3047
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 JORDANS POND LN
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City | CHARLOTTE
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State | NC
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Zip | 28214-7153
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Country | US
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Telephone | 704-648-7355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TAWANDA L DUNCAN
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Credential |
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Telephone | 704-780-3047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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