BOONDOCK EXPRESS NPI 1932978517

NPI Information

NPI: 1932978517
Provider Name: BOONDOCK EXPRESS
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization
Address: 9927 JEANETTE CIR
CHARLOTTE, NC
ZIP 28213
Phone: (980) 229-8303

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NPI Details

BOONDOCK EXPRESS is a case manager care coordinator in Charlotte, NC. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. BOONDOCK EXPRESS NPI is 1932978517. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9927 JEANETTE CIR
CHARLOTTE, NC
ZIP 28213-129
Phone: (980) 229-8303

The provider's authorized official is Hasan A Abdushahid .
The authorized official title is Owner and has the following contact phone number (980) 229-8303.

The enumeration date for this NPI number is 12/25/2023 and was last updated on 12/25/2023.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	376K00000X	Nurse's Aide		No
2	385HR2050X	Respite Care	Respite Care Camp	No
3	251C00000X	Day Training, Developmentally Disabled Services		No
4	251S00000X	Community/Behavioral Health		No
5	251X00000X	Supports Brokerage		No
6	372500000X	Chore Provider		No
7	372600000X	Adult Companion		No
8	3747P1801X	Technician	Personal Care Attendant	No
9	101YM0800X	Counselor	Mental Health	No
10	106S00000X	Behavior Technician		No
11	225800000X	Recreation Therapist		No
12	225C00000X	Rehabilitation Counselor		No
13	171M00000X	Case Manager/Care Coordinator		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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