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THE SUPPORT VILLAGE LLC
NPI 1164218368
Community/Behavioral Health in Charlotte, NC

Active since April 16, 2025
4048 EVELYN AVE, CHARLOTTE, NC 28213(980) 240-5713 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About The Support Village Llc NPPES

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

THE SUPPORT VILLAGE LLC (NPI 1164218368) is a healthcare organization registered as a community/behavioral health in Charlotte, North Carolina and active in the NPI registry since April 2025. The organization lists Jerritt Davis, Owner, as its authorized official.

NPPES Registry Identity

NPI1164218368
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameTHE SUPPORT VILLAGE LLC
Location Address4048 EVELYN AVECharlotte, NC 28213-3938
Mailing Address4111e Rose Lake Dr # 8215Charlotte, NC 28217-2858 · (980) 240-5713
Phone(980) 240-5713
Organization SubpartNo
Authorized OfficialJerritt DavisOwner · (980) 240-5713
Enumeration DateApril 16, 2025
NPPES CertifiedApril 16, 2025
✔ NPI 1164218368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4048 EVELYN AVE, Charlotte, NC 28213
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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 The Support Village LLC's NPI number?

The NPI number for The Support Village LLC is 1164218368. It was assigned to this organization in the NPPES registry on April 16, 2025.

Where is The Support Village LLC located?

The Support Village LLC is located at 4048 Evelyn Ave, Charlotte, NC 28213. The listed phone number is (980) 240-5713.

What is The Support Village LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for The Support Village LLC was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.