Mallard Creek Learning Center

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

60002874 Issued in NC

Legal business name

MALLARD CREEK LEARNING CENTER

Doing business as

Divine Health and Wellness

Practice address

8136 Browne Rd
Charlotte, NC 28269-1101

Phone

(704) 533-2870

Fax

(704) 948-2047

NPI assigned

Jun 6, 2015

Organization subpart

Yes

Parent organization

MALLARD CREEK LEARNING CENTERAs reported in NPPES

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

Authorized official

Name

Mrs. Jacqueline Denise Williams

Title

Owner

Phone

(704) 533-2870

Specialties & licenses 10

Addresses

Other identifiers 1

Other names 1

• Divine Health and Wellness Doing business as

Part of

Mallard Creek Learning Center

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

{
    "created_epoch": "1433548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433548800000",
    "number": "1508246331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8136 BROWNE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691101",
            "telephone_number": "704-533-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 BROWNE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691101",
            "telephone_number": "704-533-2870",
            "fax_number": "704-948-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD CREEK LEARNING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MALLARD CREEK LEARNING CENTER",
        "enumeration_date": "2015-06-06",
        "last_updated": "2015-06-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-533-2870",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "60002874",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILD CARE LICENSE",
            "identifier": "60002874",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emma Grace Malinowski, LCSWA
• Karen Leigh Malizia
• Meghan H Malka, RD
• Mallard Creek Chiropractic Group
• Mallard Creek Family Dentistry LLP
• Mallard Creek Therapeutic Services
• Michelle Parker Mallen, M.S, CCC-SLP
• Michelle Mallery Patel, BS
• Anna Catherine Malles, LCSWA
• Caroline E Malles

• 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 Jun 6, 2015; 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.