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Coltrane Life Center, INC.

Clinic/Center, Adult Day Care in Concord, NC. Organization (NPI-2).

NPI number1275752230
StatusActive
Last updated in NPPESFeb 14, 2013

Details

NPI
1275752230
Entity type
Organization (NPI-2)
Legal business name
Coltrane Life Center, INC.
Organization subpart
No
Enumeration date
Apr 25, 2007
Last updated
Feb 14, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA0600X Clinic/Center, Adult Day Care–NCYes
385H00000X Respite Care–NC

Practice location

321 Corban Ave Se
Concord, NC 28025-2710

Phone 704-788-1215 · Fax 704-788-1209

Mailing address

321 Corban Ave Se
Concord, NC 28025-2710

Phone 704-788-1215 · Fax 704-788-1209

Authorized official

Susan Caudle
Administrative Financial Assistant
7047881215

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