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NPI Code Detail

MEDICARE: KAPSON SENIOR QUARTERS CORP.

MEDICARE: KAPSON SENIOR QUARTERS CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1043514920
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAPSON SENIOR QUARTERS CORP.
Provider Business Mailing Address
First Line : 3600 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-4102
Country : US
Telephone Number : 704-523-4949
Fax Number :
Provider Business Practice Location Address
First Line : 3600 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-4102
Country : US
Telephone Number : 704-523-4949
Fax Number :
Authorized Official
Title or Position : GENERAL COUNSEL
Name : BRYAN HUDSON
Credential :
Telephone Number : 502-779-7683
Provider Enumeration Date : 01/06/2011
Last Update Date : 01/06/2011

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