MEDICARE: SASSY N CLASSY 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	174200000X	Meals Provider

General Provider Information

NPI Number	:	1417888900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SASSY N CLASSY LLC

Provider Business Mailing Address
First Line	:	7501 LADY BANK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-9179
Country	:	US
Telephone Number	:	743-207-4934
Fax Number	:

Provider Business Practice Location Address
First Line	:	7501 LADY BANK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-9179
Country	:	US
Telephone Number	:	743-207-4934
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LAKENDA MALACHI
Credential	:
Telephone Number	:	743-207-4934

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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