Provider Demographics
NPI:1124301205
Name:HEALTHCARE INSTITUTE OF CHARLOTTE, LLC
Entity type:Organization
Organization Name:HEALTHCARE INSTITUTE OF CHARLOTTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:NKASIOBI
Authorized Official - Last Name:NWAUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, FNP-BC
Authorized Official - Phone:704-575-5064
Mailing Address - Street 1:3547 N SHARON AMITY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-8996
Mailing Address - Country:US
Mailing Address - Phone:704-575-5064
Mailing Address - Fax:
Practice Address - Street 1:3547 N SHARON AMITY RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-8996
Practice Address - Country:US
Practice Address - Phone:704-575-5064
Practice Address - Fax:704-716-9838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-24
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4449163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3419233Medicaid
NC6602322Medicaid
NC7100691Medicaid