Provider Demographics
NPI:1164028908
Name:HOME1ST
Entity Type:Organization
Organization Name:HOME1ST
Other - Org Name:HOMECARE1ST
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:EMANI
Authorized Official - Last Name:MPUATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-208-0286
Mailing Address - Street 1:4952 MCALPINE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8547
Mailing Address - Country:US
Mailing Address - Phone:704-208-0286
Mailing Address - Fax:
Practice Address - Street 1:4952 MCALPINE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8547
Practice Address - Country:US
Practice Address - Phone:704-208-0286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health