Provider Demographics
NPI:1114203148
Name:CAROLINA STAFFING & HOME HEALTH, CO. INC.
Entity Type:Organization
Organization Name:CAROLINA STAFFING & HOME HEALTH, CO. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:UDOCHUKWU
Authorized Official - Last Name:OJIMADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-266-3591
Mailing Address - Street 1:7048 KNIGHTDALE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-8894
Mailing Address - Country:US
Mailing Address - Phone:919-266-3591
Mailing Address - Fax:919-266-3591
Practice Address - Street 1:7048 KNIGHTDALE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-8894
Practice Address - Country:US
Practice Address - Phone:919-266-3591
Practice Address - Fax:919-266-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-797251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302666Medicaid
NC5916969Medicaid