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General NPI Number Information
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NPI Number | 1841622792
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Entity Type | Organization
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Legal Business Name | CENTRALINA COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 9815 DAVID TAYLOR DR STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28262-2358
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Country | US
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Telephone | 704-385-4789
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Fax | 704-347-4710
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Provider Business Mailing Address
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Address Line | 9815 DAVID TAYLOR DR STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28262-2358
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Country | US
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Telephone | 704-385-4789
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Fax | 704-347-4710
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GERALDINE GARDNER
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Credential |
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Telephone | 704-351-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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