1912239047 NPI number — ASSURANCE COMMUNITY LONG TERM CARE LLP

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 1912239047 NPI number — ASSURANCE COMMUNITY LONG TERM CARE LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSURANCE COMMUNITY LONG TERM CARE LLP
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:
ASSURANCE HOME SOLUTIONS LLP
Provider Other Organization Name Type Code:
3
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:
1912239047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2012 HIGHWAY 160 W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29708-8401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-684-7611
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18001 DELMAS DR
Provider Second Line Business Practice Location Address:
APT1B
Provider Business Practice Location Address City Name:
CORNELIUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28031-9043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-684-7611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
RENEE
Authorized Official Middle Name:
DIONNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
704-684-7611

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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