NPI 1053275206
Abundantly Graced Community Supportive Services INC
Practice location
- Address
- 5736 N Tryon St STE 125a, Charlotte, NC 28213-6886
- Phone
- (704) 713-5652
Authorised official
- Name
- Lastarra Shawnta McDonald
- Title
- Ceo
- Phone
- (704) 819-1965
Registered specialties (10)
Peer Specialist
Primary
Addiction (Substance Use Disorder) Counselor
Mental Health Counselor
Meals Provider
Case Management Agency
Home Health Agency
Community/Behavioral Health Agency
In Home Supportive Care Agency
Adult Companion
Child Intellectual and/or Developmental Disabilities Respite Care
Registry record
- NPI
- 1053275206
- Entity type
- Organization
- NPI issued
- 11 Dec 2025
- Record last updated
- 11 Mar 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.