Provider Demographics
NPI:1003695289
Name:WILLIAMS INDEPENDENT HOME CARE LLC
Entity Type:Organization
Organization Name:WILLIAMS INDEPENDENT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:984-800-6814
Mailing Address - Street 1:PO BOX 1775
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-1775
Mailing Address - Country:US
Mailing Address - Phone:984-800-6814
Mailing Address - Fax:
Practice Address - Street 1:375 E 3RD ST STE 211
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-9708
Practice Address - Country:US
Practice Address - Phone:984-800-6814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care