Provider Demographics
NPI:1386646552
Name:COUNTY OF CALDWELL
Entity Type:Organization
Organization Name:COUNTY OF CALDWELL
Other - Org Name:CALDWELL CO. HOME HEALTH AGC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOME HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNI
Authorized Official - Phone:828-426-8438
Mailing Address - Street 1:2345 MORGANTON BLVD SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4973
Mailing Address - Country:US
Mailing Address - Phone:828-426-8401
Mailing Address - Fax:828-426-8441
Practice Address - Street 1:2345 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4973
Practice Address - Country:US
Practice Address - Phone:828-426-8401
Practice Address - Fax:828-426-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0487251E00000X
251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00713OtherNC STATE BENEFIT
NC00713OtherBLUE CROSS BLUE SHIELD
NC6009193OtherUNITED HEALTHCARE
NC00713OtherNC HEALTH CHOICE
NC3407079Medicaid
NC00713OtherNC STATE BENEFIT