Provider Demographics
NPI:1275755316
Name:CAROLINA STAFFING AND HOME HEALTH INC.
Entity Type:Organization
Organization Name:CAROLINA STAFFING AND HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
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:919-881-0277
Mailing Address - Street 1:3214 CHARLES B ROOT WYND
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5440
Mailing Address - Country:US
Mailing Address - Phone:919-881-0277
Mailing Address - Fax:919-881-0278
Practice Address - Street 1:3510 UNIVERSITY DR
Practice Address - Street 2:SUITE D
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2658
Practice Address - Country:US
Practice Address - Phone:919-881-0277
Practice Address - Fax:919-881-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2523251E00000X
NCMHL-092-653322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601054Medicaid
NC7704012Medicaid
NC3409683Medicaid
NC6604088Medicaid