Provider Demographics
NPI:1033971155
Name:GROWING IN CARE OF CHARLOTTE, LLC
Entity Type:Organization
Organization Name:GROWING IN CARE OF CHARLOTTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADIAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-890-2343
Mailing Address - Street 1:3710 CLENDON CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3133
Mailing Address - Country:US
Mailing Address - Phone:704-890-2343
Mailing Address - Fax:
Practice Address - Street 1:3710 CLENDON CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-3133
Practice Address - Country:US
Practice Address - Phone:704-890-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health