MEDICARE: KRISTYNA HERITAGE INVESTMENT

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1417800897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTYNA HERITAGE INVESTMENT

Provider Business Mailing Address
First Line	:	516 GOLDSTAFF LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5689
Country	:	US
Telephone Number	:	704-957-9721
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 GOLDSTAFF LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5689
Country	:	US
Telephone Number	:	704-957-9721
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AYELE F AYITE
Credential	:
Telephone Number	:	704-957-9721

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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