Provider Demographics
| NPI: | 1033880943 |
|---|---|
| Name: | CASSIOPEIA'S HOME CARE AGENCY |
| Entity Type: | Organization |
| Organization Name: | CASSIOPEIA'S HOME CARE AGENCY |
| Other - Org Name: | CASSIOPEIAS HOME CARE AGENCY |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CASSIOPIA |
| Authorized Official - Middle Name: | VICTORIA |
| Authorized Official - Last Name: | TINSLEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 919-673-3932 |
| Mailing Address - Street 1: | 142 TOWERVIEW CT STE 231 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CARY |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27513-3595 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 919-673-3932 |
| Mailing Address - Fax: | 919-573-9492 |
| Practice Address - Street 1: | 142 TOWERVIEW CT STE 231 |
| Practice Address - Street 2: | |
| Practice Address - City: | CARY |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27513-3595 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 919-673-3932 |
| Practice Address - Fax: | 919-673-3932 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-09-22 |
| Last Update Date: | 2022-08-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 253Z00000X | Agencies | In Home Supportive Care | ||
| No | 251G00000X | Agencies | Hospice Care, Community Based | ||
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | ||
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | ||
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | Group - Single Specialty | |
| No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Single Specialty | |
| No | 385H00000X | Respite Care Facility | Respite Care | ||
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |
