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General NPI Number Information
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NPI Number | 1912239047
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Entity Type | Organization
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Legal Business Name | ASSURANCE COMMUNITY LONG TERM CARE LLP
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Dates
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Enumeration Date | 01/29/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 18001 DELMAS DR APT1B
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City | CORNELIUS
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State | NC
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Zip | 28031-9043
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Country | US
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Telephone | 704-684-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 HIGHWAY 160 W
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City | FORT MILL
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State | SC
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Zip | 29708-8401
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Country | US
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Telephone | 704-684-7611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RENEE DIONNE BROWN
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Credential |
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Telephone | 704-684-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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