Provider Demographics
NPI:1477140580
Name:HOME AGAIN HOME CARE
Entity Type:Organization
Organization Name:HOME AGAIN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITNEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-782-9611
Mailing Address - Street 1:151 LARCK CREST LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-8205
Mailing Address - Country:US
Mailing Address - Phone:336-782-9611
Mailing Address - Fax:336-656-2178
Practice Address - Street 1:2572 DAVIE AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-9249
Practice Address - Country:US
Practice Address - Phone:336-448-0567
Practice Address - Fax:336-656-2178
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME AGAIN SENIOR LIVING COMMUNITIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1043876493Medicaid