Provider Demographics
NPI:1326550658
Name:CARE ADVANTAGE-NORTH CAROLINA LLC
Entity Type:Organization
Organization Name:CARE ADVANTAGE-NORTH CAROLINA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-323-9464
Mailing Address - Street 1:10041 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4815
Mailing Address - Country:US
Mailing Address - Phone:804-323-9464
Mailing Address - Fax:804-331-0165
Practice Address - Street 1:3231 AVENT FERRY RD STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606
Practice Address - Country:US
Practice Address - Phone:804-323-9464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WH0200X, 251J00000X, 253Z00000X
NC364SH0200X, 3747P1801X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty