NPI 1285905125

Life Line Connection LLC

Organisation Exclusive Provider Organization Charlotte, NC

Practice location

Address: 9635 Southern Pine Blvd, Charlotte, NC 28273-5558
Phone: (704) 231-9481
Mailing address: 6210 Candlewood Dr, Charlotte, NC 28210-4506

Authorised official

Name: Kamesha Denise Harris
Title: Owner
Phone: (704) 231-9481

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in North Carolina →

Registry record

NPI: 1285905125
Entity type: Organization
NPI issued: 24 Jan 2012
Record last updated: 24 Jan 2012

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.