Provider Demographics
NPI:1609087345
Name:SPECIAL KARE FOR SPECIAL KIDS,LLC
Entity Type:Organization
Organization Name:SPECIAL KARE FOR SPECIAL KIDS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT-DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:H
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:704-860-3501
Mailing Address - Street 1:2000 RHYNE CARTER RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2868
Mailing Address - Country:US
Mailing Address - Phone:704-860-3501
Mailing Address - Fax:704-865-0895
Practice Address - Street 1:2000 RHYNE CARTER RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2868
Practice Address - Country:US
Practice Address - Phone:704-860-3501
Practice Address - Fax:704-865-0895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300039KMedicaid