Provider Demographics
NPI:1518398130
Name:CAROLINA LIFESTYLES SENIOR CARE, INC
Entity Type:Organization
Organization Name:CAROLINA LIFESTYLES SENIOR CARE, INC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:R
Authorized Official - Last Name:AIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-294-0081
Mailing Address - Street 1:4615 DUNDAS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1650
Mailing Address - Country:US
Mailing Address - Phone:336-294-0081
Mailing Address - Fax:336-294-3321
Practice Address - Street 1:4615 DUNDAS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1650
Practice Address - Country:US
Practice Address - Phone:336-294-0081
Practice Address - Fax:336-294-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-07
Last Update Date:2013-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3003253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care