MEDICARE: TWENTY TWO PACK MANAGEMENT CORP

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1811141104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWENTY TWO PACK MANAGEMENT CORP

Provider Business Mailing Address
First Line	:	1501 ZION CHURCH RD E
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-6827
Country	:	US
Telephone Number	:	704-782-1100
Fax Number	:	704-721-3144

Provider Business Practice Location Address
First Line	:	1501 ZION CHURCH RD E
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-6827
Country	:	US
Telephone Number	:	704-782-1100
Fax Number	:	704-721-3144

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	AMY BLACK
Credential	:
Telephone Number	:	704-782-1100

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	11/13/2008

Similar Medicare Providers

1346074481 — OCTOBER ROAD INC
Practice Location Address:

1501 ZION CHURCH RD E
CONCORD, NC
28025-6827

Practice Phone: 724-996-2744
Practice Fax:

1629401336 — HBP LEASECO, LLC
Practice Location Address:

1501 ZION CHURCH RD E
CONCORD, NC
28025-6827

Practice Phone: 704-782-1100
Practice Fax:

1528319902 — MS. ANNETTE ELEANOR THOMPSON LCAS
Practice Location Address:

616 COLONNADE DR
CHARLOTTE, NC
28205-6827

Practice Phone: 704-273-3942
Practice Fax:

1720732464 — BONITA A GRAHAM
Practice Location Address:

616 COLONNADE DR
CHARLOTTE, NC
28205-6827

Practice Phone: 704-273-3942
Practice Fax:

1275282154 — D'ASIA MACKENZIE PHRONEBARGER LCMHC-A
Practice Location Address:

616 COLONNADE DR
CHARLOTTE, NC
28205-6827

Practice Phone: 704-273-3942
Practice Fax: 704-749-2305

1992412431 — DAYMARK RECOVERY SERVICES INC
Practice Location Address:

616 COLONNADE DR
CHARLOTTE, NC
28205-6827

Practice Phone: 704-939-1133
Practice Fax: 704-983-2636

Directions to “TWENTY TWO PACK MANAGEMENT CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.