MEDICARE: GREATER CHANGES CENTER HOME CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1699620922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER CHANGES CENTER HOME CARE

Provider Business Mailing Address
First Line	:	4927 REEDMONT LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-1631
Country	:	US
Telephone Number	:	980-420-6864
Fax Number	:

Provider Business Practice Location Address
First Line	:	9625 DAVID TAYLOR DR STE 121
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-2362
Country	:	US
Telephone Number	:	980-420-6864
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENIQUE SMITH
Credential	:
Telephone Number	:	980-322-3228

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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