Provider Demographics
NPI:1104022979
Name:HOMECARE LINK, LLC
Entity Type:Organization
Organization Name:HOMECARE LINK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-302-1821
Mailing Address - Street 1:5200 PARK ROAD
Mailing Address - Street 2:SUITE 131
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3749
Mailing Address - Country:US
Mailing Address - Phone:704-302-1821
Mailing Address - Fax:704-315-5099
Practice Address - Street 1:5200 PARK ROAD
Practice Address - Street 2:SUITE 131
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3749
Practice Address - Country:US
Practice Address - Phone:704-302-1821
Practice Address - Fax:704-315-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3638251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601736Medicaid
NC3418436Medicaid