MEDICARE: LOTS LORD OF THE STREETS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	177F00000X	Lodging Provider
3	251B00000X	Case Management Agency
4	385H00000X	Respite Care
5	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1396536488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTS LORD OF THE STREETS

Provider Business Mailing Address
First Line	:	9910 STEWART SPRING LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-2170
Country	:	US
Telephone Number	:	704-200-4150
Fax Number	:

Provider Business Practice Location Address
First Line	:	9910 STEWART SPRING LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-2170
Country	:	US
Telephone Number	:	704-200-4150
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT - CEO
Name	:	DR. DOROTHY LOUISE ALEXANDER CLARK
Credential	:	EDD
Telephone Number	:	704-200-4150

Provider Enumeration Date	:	05/16/2025
Last Update Date	:	12/08/2025

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Directions to “LOTS LORD OF THE STREETS ” Practice Location

Language	Start Address	Practice Location

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