FIVE STAR QUALITY CARE - OBX OPERATOR LLC NPI 1194877001

NPI Information

FIVE STAR QUALITY CARE - OBX OPERATOR, LLC is an assisted living facility in Charlotte, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. FIVE STAR QUALITY CARE - OBX OPERATOR, LLC NPI is 1194877001. The provider is registered as an organization entity type.
The provider Is Doing Business As Legacy Heights Senior Living Community.

The provider's business location address is:

11230 BALLANTYNE TRACE COURT
CHARLOTTE, NC
ZIP 28277
Phone: (704) 544-7220
Fax: (704) 544-7221

The provider's authorized official is Katherine E Potter .
The authorized official title is President & Chief Executive Officer and has the following contact phone number (617) 796-8387.

The CLIA number assigned to this NPI record is 34D1089262 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 3/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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