QUEEN CITY ASSISTED LIVING
NPI 1356789143
Custodial Care Facility - Adult Care Home in Charlotte, NC
NPI Status: Active since June 13, 2013
Contact Information
1700 MONTANA DR
CHARLOTTE, NC
ZIP 28216
Phone: (704) 393-2824
Fax: (704) 393-3476
- Organization
- Custodial Care Facility
- Adult Care Home
- CLIA Number: 34D2066920
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 10-06-2025
About QUEEN CITY ASSISTED LIVING
This page provides the complete NPI Profile along with additional information for Queen City Assisted Living, a provider established in Charlotte, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1356789143 assigned on June 2013. The practitioner's primary taxonomy code is 311ZA0620X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Queen City Assisted Living. The authorized official of this NPI record is Charles E Trefzger (Manager)
- NPI
- 1356789143
- Provider Legal Name
- WP-CHARLOTTE AL HOLDINGS, LLC
- Other Organization Name
- QUEEN CITY ASSISTED LIVING
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1700 MONTANA DR CHARLOTTE, NC 28216
- Location Phone
- (704) 393-2824
- Location Fax
- (704) 393-3476
- Mailing Address
- PO BOX 2568 HICKORY, NC 28603
- Mailing Phone
- (828) 261-7304
- Mailing Fax
- (704) 393-3476
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-13-2013
- Last Update Date
- 10-26-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Custodial Care Facility Adult Care Home
- Taxonomy Code
- 311ZA0620X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | HAL-060-126 (NC) |
| 2 | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2066920
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- October 07, 2023
- Certificate Expiration Date
- October 06, 2025
- Laboratory Director
- PAUL AKOSAH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Queen City Assisted Living to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for QUEEN CITY ASSISTED LIVING
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 5 | 6 | 7 | 8 | 9 | 1 | 4 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 10 | 6 | 14 | 8 | 18 | 1 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 0 + 6 + 1 + 4 + 8 + 1 + 8 + 1 + 8 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1356789143 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1891906194 | HELTON MANOR WEST ASSISTED LIVING Organization | Assisted Living Facility | 1700 MONTANA DR CHARLOTTE, NC 28216 (704) 393-2870 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356789143, enumerated in the NPI registry as an "organization" on June 13, 2013
The provider is located at 1700 Montana Dr Charlotte, Nc 28216 and the phone number is (704) 393-2824
This medical organization specializes in Custodial Care Facility with taxonomy code 311ZA0620X with a focus in Adult Care Home
The provider's CLIA number is 34D2066920 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 13, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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