Provizions Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROVIZIONS CARE LLC

Doing business as

Provizions Transitional Housing

Practice address

424 Lakewood Ave
Charlotte, NC 28208-3148

Phone

(704) 963-7552

Fax

(774) 307-2797

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Latasha U ProssNPI 1750961470

Title

Ceo

Phone

(704) 963-7552

Specialties & licenses 5

Addresses

Other names 1

• PROVIZIONS TRANSITIONAL HOUSING Doing business as

Tax ID family

Provizions Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Provizions Care LLC

  • Community/Behavioral Health Agency
  • Concord, NC
  • NPI 1316718067
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latasha Pross

  • Behavior Technician
  • Concord, NC
  • NPI 1750961470
  NPD Authorized official

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1528513983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5835 EXECUTIVE CENTER DR STE 101F",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128901",
            "telephone_number": "704-963-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 LAKEWOOD AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083148",
            "telephone_number": "704-963-7552",
            "fax_number": "774-307-2797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "597 LOVE ST",
            "address_purpose": "LOCATION",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027",
            "country_code": "US",
            "telephone_number": "704-963-7552",
            "fax_number": "774-307-2797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7047 Waterwheel St SW",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280256746",
            "country_code": "US",
            "telephone_number": "704-963-7552",
            "fax_number": "774-307-2797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIZIONS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "PROSS",
        "authorized_official_first_name": "LATASHA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-963-7552"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIZIONS TRANSITIONAL HOUSING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.