Echo Park Integrated Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ECHO PARK INTEGRATED INC

Doing business as

Echo Park Healthcare Agency

Practice address

1313 N Tryon St
Charlotte, NC 28206-2721

Phone

(704) 604-5677

NPI assigned

May 14, 2020

Organization subpart

No

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

Authorized official

Name

Grace David

Title

President

Phone

(704) 604-5677

Specialties & licenses 2

Addresses

Other names 2

• ECHO PARK HEALTHCARE AGENCY Doing business as
• ECHO PARK INTEGRATED INC Former legal business name

Locations

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1487276242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 CAMERON CREEK DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062721",
            "telephone_number": "704-604-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO PARK INTEGRATED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-604-5677"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECHO PARK HEALTHCARE AGENCY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ECHO PARK INTEGRATED INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.