OrganizationActive
Davenport Family Services LLC
NPI 1225810609 · Intellectual Disabilities Intermediate Care Facility · Charlotte, NC
Provider details
- NPI number
- 1225810609
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jermaine Davenport, Ceo(828) 279-4443
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Respite Care385H00000X
Respite Care Facility
Nursing & Custodial Care Facilities
- Adult Care Home Facility311ZA0620X
Nursing & Custodial Care Facilities
Practice location
3412 Thistle Bloom Ct
Charlotte, NC 28269-1309
Phone: (980) 384-8103
Approximate (ZIP-level) locationGet directions
Mailing address
3412 Thistle Bloom Ct
Charlotte, NC 28269-1309
Registry dates
- Enumerated
- 2023-10-19
- Last updated
- 2023-10-19
- Certified
- 2023-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.