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Mallard Creek Learning Center

Home Health in Charlotte, NC. Organization (NPI-2).

NPI number1508246331
StatusActive
Last updated in NPPESJun 6, 2015

Details

NPI
1508246331
Entity type
Organization (NPI-2)
Legal business name
Mallard Creek Learning Center
Organization subpart
Yes
Enumeration date
Jun 6, 2015
Last updated
Jun 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health60002874NCYes
251B00000X Case Management––
251C00000X Day Training, Developmentally Disabled Services––
251G00000X Hospice Care, Community Based––
251J00000X Nursing Care––
251K00000X Public Health or Welfare––
251S00000X Community/Behavioral Health––
252Y00000X Early Intervention Provider Agency––
253J00000X Foster Care Agency––
253Z00000X In Home Supportive Care––

Other names

  • Divine Health And Wellness (Doing Business As)

Practice location

8136 Browne Rd
Charlotte, NC 28269-1101

Phone 704-533-2870 · Fax 704-948-2047

Mailing address

8136 Browne Rd
Charlotte, NC 28269-1101

Phone 704-533-2870

Authorized official

Jacqueline Denise Williams
Owner
7045332870

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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