K&R Glowing Pride Residential Services of North Carolina

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

K&R GLOWING PRIDE RESIDENTIAL SERVICES OF NORTH CAROLINA

Practice address

11512 Spring Laurel Dr
Charlotte, NC 28215-4654

Phone

(317) 517-7688

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Keyana Rice

Title

Owner

Phone

(317) 517-7688

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1750161568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 MATERA DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347719155",
            "telephone_number": "317-517-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 SPRING LAUREL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154654",
            "telephone_number": "317-517-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K&R GLOWING PRIDE RESIDENTIAL SERVICES OF NORTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-30",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "KEYANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-517-7688",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 2, 2023; 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.