Providastaff, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDASTAFF, LLC

Practice address

4045 Amber Leigh Way Dr
Charlotte, NC 28269-2374

Phone

(704) 609-5336

NPI assigned

Apr 6, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Lewis

Title

Owner

Phone

(704) 609-5336

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1467695494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 AMBER LEIGH WAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 AMBER LEIGH WAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692374",
            "telephone_number": "704-609-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDASTAFF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-609-5336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providence Behavioral Health
• Providence Behavioral Health PA
• Providence Counseling & Training, Inc.

• Home Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.