MEDICARE: KENNEDYSTRONG FOUNDATION

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1851282107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNEDYSTRONG FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 7158
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-1537
Country	:	US
Telephone Number	:	704-647-1432
Fax Number	:

Provider Business Practice Location Address
First Line	:	9889 LEGOLAS LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-7020
Country	:	US
Telephone Number	:	704-647-1432
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	HELEN MASON
Credential	:
Telephone Number	:	704-647-1432

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	03/11/2026

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Directions to “KENNEDYSTRONG FOUNDATION ” Practice Location

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