Provider Demographics
NPI:1013186303
Name:MCLEAN ENTERPRISE, INC
Entity Type:Organization
Organization Name:MCLEAN ENTERPRISE, INC
Other - Org Name:HOME AND FAMILY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-865-1000
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:NC
Mailing Address - Zip Code:28386-0325
Mailing Address - Country:US
Mailing Address - Phone:910-865-1000
Mailing Address - Fax:
Practice Address - Street 1:946 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-2624
Practice Address - Country:US
Practice Address - Phone:910-865-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2859251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408178Medicaid