MEDICARE: FAMILY CARE SERVICES, 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
1	251S00000X	Community/Behavioral Health Agency		NC

General Provider Information

NPI Number	:	1215125406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	1914 J N PEASE PL
Second Line	:	STE, 110
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-919-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1914 J N PEASE PL
Second Line	:	STE, 110
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-919-3500
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MS. DARLENE TATE
Credential	:	P.C.
Telephone Number	:	704-421-2930

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	09/02/2015

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Directions to “FAMILY CARE SERVICES, LLC ” Practice Location

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