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NPI Code Detail

MEDICARE: ENSTART & ASSOCIATES HOME CARE AGENCY

MEDICARE: ENSTART & ASSOCIATES HOME CARE AGENCY
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1154909398
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENSTART & ASSOCIATES HOME CARE AGENCY
Provider Business Mailing Address
First Line : 12524 HAMMERSMITH CT
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-0433
Country : US
Telephone Number : 919-399-3146
Fax Number :
Provider Business Practice Location Address
First Line : 10022 UNIVERSITY CITY BLVD STE A
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-3622
Country : US
Telephone Number : 919-399-3146
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RENEE WHITTED LACY
Credential :
Telephone Number : 919-399-3146
Provider Enumeration Date : 03/30/2021
Last Update Date : 03/30/2021

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Directions to “ENSTART & ASSOCIATES HOME CARE AGENCY ” Practice Location

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