All Medicaid billing entities listing HENNESSEE, TRACY (EXECUTIVE DIRECTOR) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| North Carolina | 1 | $17K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | MALLARD RIDGE LLC | KERNERSVILLE, NC | Assisted Living Facility | $17K |