Provider Demographics
NPI:1245420561
Name:CAROLINAS CARE, LLC
Entity Type:Organization
Organization Name:CAROLINAS CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUVERNAL
Authorized Official - Middle Name:O
Authorized Official - Last Name:OGBUNEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-562-9452
Mailing Address - Street 1:6218 IDLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-4731
Mailing Address - Country:US
Mailing Address - Phone:704-562-9452
Mailing Address - Fax:704-719-9727
Practice Address - Street 1:5624 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 125
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8832
Practice Address - Country:US
Practice Address - Phone:704-562-9452
Practice Address - Fax:704-719-9727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3615251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health