| Garden Of Life, Inc | |
|
8339 Fox Swamp Rd Charlotte NC 28215-9011 | |
| (980) 309-6863 | |
| Not Available |
| Full Name | Garden Of Life, Inc |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 8339 Fox Swamp Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Deshall Hill (OWNER) |
| Authorized Official Contact | 8903096863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden Of Life, Inc 8339 Fox Swamp Rd Charlotte NC 28215-9011 Ph: (845) 728-9166 | Garden Of Life, Inc 8339 Fox Swamp Rd Charlotte NC 28215-9011 Ph: (980) 309-6863 |
| NPI Number | 1477174407 |
|---|---|
| Provider Enumeration Date | 04/30/2020 |
| Last Update Date | 08/13/2020 |
| Certification Date | 08/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477174407 | NPI | - | NPPES |
| 171M00000X | Medicaid | NC | |
| 225I0000X | Medicaid | NC | |
| 251S00000X | Medicaid | NC | |
| 106S0000X | Medicaid | NC | |
| 251B00000X | Medicaid | NC | |
| 302R0000X | Medicaid | NC | |
| 1041I0000X | Medicaid | NC | |
| 22420000X | Medicaid | NC | |
| 2260000X | Medicaid | NC | |
| 305R0000X | Medicaid | NC | |
| 363L0000X | Medicaid | NC | |
| 302F0000X | Medicaid | NC | |
| 106H0000X | Medicaid | NC | |
| 175T0000X | Medicaid | NC | |
| 164W0000X | Medicaid | NC |
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