MEDICARE: GIFTED LIVING HOME SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	320700000X	Physical Disabilities Residential Treatment Facility
3	320800000X	Mental Illness Community Based Residential Treatment Facility
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1356286249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFTED LIVING HOME SERVICES

Provider Business Mailing Address
First Line	:	4224 STONEYGREEN LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-7092
Country	:	US
Telephone Number	:	704-713-8361
Fax Number	:

Provider Business Practice Location Address
First Line	:	3913 BEARWOOD AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-1329
Country	:	US
Telephone Number	:	704-713-8361
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. VINCENT ABLE
Credential	:
Telephone Number	:	704-713-8361

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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