1710286950 NPI number — GENTLE LOVING TOUCH,INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710286950 NPI number — GENTLE LOVING TOUCH,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENTLE LOVING TOUCH,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710286950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1518 DUCKWORTH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28208-4315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-953-2676
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1518 DUCKWORTH AVE
Provider Second Line Business Practice Location Address:
1518 DUCKWORTH AVE.
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28208-4315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-953-2676
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LATTER
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
E.SMITH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
704-953-2676

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  334324 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)