CONCRETE ROSES LIFE CENTER (NPI# 1508360892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508360892 |
| Entity Type | Organization |
| Organization Name | CONCRETE ROSES LIFE CENTER |
| Practice Address |
5960 Fairview Rd Ste 323 Charlotte NC 28210-3102 |
| Mailing Address |
2108 Deer Meadows Dr Waxhaw NC 28173-7196 |
| Practice Telephone | 9802630991 |
| Mailing Telephone | 7042565169 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |
| Authorized Official Name | SHAUKURA MANDISA BROWN (CEO) |
| Authorized Official Telephone | 9802630991 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities | ||
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities | ||
| N | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
Ambulatory Health Care Facilities | ||
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| N | 385HR2050X |
Respite Care Specialization: Respite Care Camp |
Respite Care Facility | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
5960 FAIRVIEW RD STE 323 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-3102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767785 | Season of Change, Pllc | Clinic/Center | 933 Louise Ave # 407, Charlotte, NC 28204-2147 | 2020-10-10 |
| 1164038782 | B&g Counseling Services Pllc | Clinic/Center | 11220 Elm Ln Ste 200, Charlotte, NC 28277-0450 | 2020-09-18 |
| 1477166197 | Compass Counseling and Consulting LLC | Clinic/Center | 8411 Habersham Pointe Cir, Charlotte, NC 28226-4792 | 2020-08-24 |
| 1790340172 | Kolb Counseling Group Pllc | Clinic/Center | 6747 Fairview Rd Ste C, Charlotte, NC 28210-3359 | 2019-05-01 |
| 1316400088 | United Primary Diagnostic Center | Clinic/Center | 2103 N Graham St Ste B, Charlotte, NC 28206-2548 | 2019-04-10 |
| 1174093751 | Lineberger Christian Counseling, Pllc | Clinic/Center | 1811 Sardis Road North, Suite 207, Charlotte, NC 28270 | 2018-11-27 |
| 1396225348 | Real Talk Counseling | Clinic/Center | 2128 Mcclintock Rd, Charlotte, NC 28205-5114 | 2018-08-20 |
| 1811475569 | Art of Care Counseling | Clinic/Center | 6338 Shining Rock Ct, Charlotte, NC 28277-0118 | 2018-08-04 |
| 1891284675 | Ashakti Wellness & Yoga LLC | Clinic/Center | 1200 E Morehead St Ste 20d, Charlotte, NC 28204-2872 | 2018-05-07 |
| 1558860239 | Advanced Community Services LLC | Clinic/Center | 4700 Farm Pond Ln, Charlotte, NC 28212-8500 | 2018-02-07 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.