Provider Demographics
NPI:1376628578
Name:GIBSON CARE CORP.
Entity Type:Organization
Organization Name:GIBSON CARE CORP.
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CREIGHTON
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-924-9909
Mailing Address - Street 1:PO BOX 7138
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-7138
Mailing Address - Country:US
Mailing Address - Phone:704-924-9909
Mailing Address - Fax:704-924-9165
Practice Address - Street 1:608 SIGNAL HILL DRIVE EXT
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-4353
Practice Address - Country:US
Practice Address - Phone:704-924-9909
Practice Address - Fax:704-924-9165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3016251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418026Medicaid
NC6601285Medicaid