Ettalove Family Care Home

Primary specialty

Ambulatory Family Planning FacilityTaxonomy code 261QA0005X

License

FCL-060-072 Issued in NC

Legal business name

ETTALOVE FAMILY CARE HOME

Practice address

1951 Dietrich LN
Charlotte, NC 28262-3526

Phone

(704) 509-5596

Fax

(704) 509-5596

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa Yvette Washington

Title

Administrator

Phone

(704) 509-5596

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1952560997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 DIETRICH LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623526",
            "telephone_number": "704-509-5596",
            "fax_number": "704-509-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 DIETRICH LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623526",
            "telephone_number": "704-509-5596",
            "fax_number": "704-509-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETTALOVE FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-509-5596",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "NC",
            "license": "FCL-060-072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805172",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Cecile Etheridge, LCMHC
• Jennifer Majors Ethridge, LCSW
• David Rubben Etienne, MD
• Shango Shembo Etienne, D.D.S
• Michael E. Etomi, MD
• Adiaha Ette
• Amber Maurer Ettell, AGACNP
• Kevin Etter, MD
• Christina Ann Ettesen, LCMHC
• Ajike Ogunsulire Etumadu

• Ambulatory Family Planning Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ambulatory Family Planning Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.