Charlotte MC LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

CHARLOTTE MC LLC

Practice address

9108 Reames Rd
Charlotte, NC 28216-1824

Phone

(980) 655-2032

NPI assigned

Mar 25, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennilee M Richardson

Title

Cfo

Phone

(919) 621-2093

Specialties & licenses 1

Addresses

Other names 1

• Northlake House Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1417759028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 WADE PARK BLVD STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074191",
            "telephone_number": "919-371-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9108 REAMES RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282161824",
            "telephone_number": "980-655-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE MC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JENNILEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-621-2093"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northlake House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.