DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: INNOVATIVE SENIOR CARE HOME HEALTH OF CHARLOTTE LLC

MEDICARE: INNOVATIVE SENIOR CARE HOME HEALTH OF CHARLOTTE LLC
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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1073251880
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNOVATIVE SENIOR CARE HOME HEALTH OF CHARLOTTE LLC
Provider Business Mailing Address
First Line : PO BOX 51266
Second Line :
City : LAFAYETTE
State : LA
Zip : 70505-1266
Country : US
Telephone Number : 337-233-1307
Fax Number : 337-443-4154
Provider Business Practice Location Address
First Line : 5800 OLD PROVIDENCE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-6872
Country : US
Telephone Number : 704-365-8551
Fax Number : 704-921-2055
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : NICHOLAS GACHASSIN III
Credential :
Telephone Number : 337-233-1307
Provider Enumeration Date : 05/23/2022
Last Update Date : 05/23/2022

Similar Medicare Providers

1013967231 — ARCLP-CHARLOTTE, LLC
Practice Location Address:
5800 OLD PROVIDENCE RD
CHARLOTTE, NC
28226-6872
Practice Phone: 704-365-8551
Practice Fax: 704-366-4270
1376958082 — NEELAM SAMIT DESAI
Practice Location Address:
5800 OLD PROVIDENCE RD
CHARLOTTE, NC
28226-6872
Practice Phone: 704-365-8551
Practice Fax:
1033507462 — TONYA FARRELL PT
Practice Location Address:
5800 OLD PROVIDENCE RD
CHARLOTTE, NC
28226-6872
Practice Phone: 704-661-0902
Practice Fax:
1790295384 — HADEN KNIGHT THOMAS DPT
Practice Location Address:
5800 OLD PROVIDENCE RD
CHARLOTTE, NC
28226-6872
Practice Phone: 704-869-2248
Practice Fax:
1629795190 — BKD PERSONAL ASSISTANCE SERVICES LLC
Practice Location Address:
5800 OLD PROVIDENCE RD STE PL1
CHARLOTTE, NC
28226-6872
Practice Phone: 704-887-0172
Practice Fax:
1053029801 — CLAUDE GOODMAN SHAW JR. PTA
Practice Location Address:
5800 OLD PROVIDENCE RD
CHARLOTTE, NC
28226-6872
Practice Phone: 704-365-8551
Practice Fax: 704-365-8505

Directions to “INNOVATIVE SENIOR CARE HOME HEALTH OF CHARLOTTE LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.