Provider Demographics
NPI:1477747590
Name:ADULT CARE & SHARE CENTER
Entity Type:Organization
Organization Name:ADULT CARE & SHARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-567-2700
Mailing Address - Street 1:6709 IDLEWILD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-0592
Mailing Address - Country:US
Mailing Address - Phone:704-567-2700
Mailing Address - Fax:704-567-0706
Practice Address - Street 1:6709 IDLEWILD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-0592
Practice Address - Country:US
Practice Address - Phone:704-567-2700
Practice Address - Fax:704-567-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408592Medicaid