B.A.C.'S Place

LBN: Betty Ann Clark
B.A.C.'S Place is an health care organization with primary practice located at 9709 Avensong Crossing Dr , Charlotte NC 28215-8078. The organization recently has only one registered license in Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Betty Ann Clark can be contacted via phone (704) 532-1071, or through Clark, Betty Ann via phone 70453231071.

Contact Information

Primary practice address
9709 Avensong Crossing Dr Charlotte NC 28215-8078
Phone: (704) 532-1071
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Betty Ann
Phone: 70453231071

Health care specialties

SpecialtyCodeLicense #State
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X 60001581 North Carolina

Profile Details

NPI number 1689710006
LBN Legal business name Betty Ann Clark
DBA Doing business as B.A.C.'S Place
Authorized official Clark, Betty Ann
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689710006 NPPES
North Carolina MEDICAID 3409246

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