Provider Demographics
NPI:1073834149
Name:BEACON OF HOPE HOME CARE SERVICES
Entity Type:Organization
Organization Name:BEACON OF HOPE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-536-0829
Mailing Address - Street 1:2028 WOODLAND DR STE A-3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6356
Mailing Address - Country:US
Mailing Address - Phone:704-536-0829
Mailing Address - Fax:704-536-0828
Practice Address - Street 1:2028 WOODLAND DR STE A-3
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6356
Practice Address - Country:US
Practice Address - Phone:704-536-0829
Practice Address - Fax:704-536-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health