Provider Demographics
NPI:1376694091
Name:HOMECARE FOR THE CAROLINAS
Entity Type:Organization
Organization Name:HOMECARE FOR THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-335-8488
Mailing Address - Street 1:9414 ALBEMARLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3346
Mailing Address - Country:US
Mailing Address - Phone:704-724-7041
Mailing Address - Fax:704-335-8477
Practice Address - Street 1:7402 FRANCES IRENE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-9929
Practice Address - Country:US
Practice Address - Phone:704-335-8488
Practice Address - Fax:704-335-8488
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE FOR THE CAROLINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3551251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601599Medicaid