1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Custodial Care Facility
  6. NPI Profile

NORTHLAKE HOUSE
NPI 1063964823
Custodial Care Facility - Adult Care Home in Charlotte, NC

Active since October 27, 2016CLIA 34D2130089 · Waiver
9108 REAMES RD, CHARLOTTE, NC 28216(980) 859-6000 Get Directions Write a Review

NPPES record last updated: November 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 2, 2021, Oct 27, 2016 (2 updates tracked since 2016).

About Northlake House NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHLAKE HOUSE (NPI 1063964823) is a healthcare organization registered as an adult care home in Charlotte, North Carolina and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through May 1, 2027 and lists Charles E Trefzger, Manager, as its authorized official.

NPPES Registry Identity

NPI1063964823
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameNORTHLAKE AL HOLDINGS, LLC
Location Address9108 REAMES RDCharlotte, NC 28216-1824
Mailing AddressPo Box 2568Hickory, NC 28603-2568 · (828) 322-5535 · Fax (828) 326-8115
Phone(980) 859-6000
Organization SubpartNo
Authorized OfficialCharles E TrefzgerManager · (828) 322-5535
Enumeration DateOctober 27, 2016
Last NPPES UpdateNovember 2, 20212 updates tracked since enumeration
NPPES CertifiedNovember 2, 2021
✔ NPI 1063964823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
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.
Also ListedAssisted Living FacilityTaxonomy 310400000X · License HAL060150 (NC)
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
9108 REAMES RD, Charlotte, NC 28216
Open in Google Maps ↗

Other Names 1

Doing Business AsNorthlake House

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2130089

Northlake House · Charlotte, NC
Active · expires May 1, 2027
CLIA Number34D2130089
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 2, 2025
Certificate Expiration DateMay 1, 2027
Laboratory DirectorPate Wilkerson
Laboratory Phone(980) 859-6000
Laboratory LocationNorthlake House9108 Reames Road, Charlotte, NC 28216
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLOTTE MC LLC
Custodial Care Facility (Adult Care Home)
9108 REAMES RD
CHARLOTTE, NC 28216
Mecklenburg County (980) 655-2032
FRIENDSHIP ENTERPRISES, LLC
Assisted Living Facility
9108 REAMES RD
CHARLOTTE, NC 28216
Mecklenburg County (704) 597-7575

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northlake Al Holdings, LLC's NPI number?

The NPI number for Northlake Al Holdings, LLC is 1063964823. It was assigned to this organization in the NPPES registry on October 27, 2016. The provider is doing business as Northlake House.

Where is Northlake Al Holdings, LLC located?

Northlake Al Holdings, LLC is located at 9108 Reames Rd, Charlotte, NC 28216. The listed phone number is (980) 859-6000.

What is Northlake Al Holdings, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Northlake Al Holdings, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2130089) is associated with this NPI, valid through May 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northlake Al Holdings, LLC was last updated on November 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.