Provider Demographics
NPI:1023217270
Name:DOVE PERSONAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:DOVE PERSONAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA QP
Authorized Official - Phone:919-786-4388
Mailing Address - Street 1:3900 BARRETT DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6641
Mailing Address - Country:US
Mailing Address - Phone:919-786-4388
Mailing Address - Fax:919-786-4399
Practice Address - Street 1:327 N QUEEN ST
Practice Address - Street 2:STE. 306
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4984
Practice Address - Country:US
Practice Address - Phone:252-522-4676
Practice Address - Fax:252-522-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408237Medicaid
NC6601734Medicaid