Provider Demographics
NPI:1568592194
Name:CAPE FEAR HOME CARE OF WILMINGTON, INC.
Entity Type:Organization
Organization Name:CAPE FEAR HOME CARE OF WILMINGTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-343-1184
Mailing Address - Street 1:513 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-4634
Mailing Address - Country:US
Mailing Address - Phone:910-343-1184
Mailing Address - Fax:910-763-7416
Practice Address - Street 1:513 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-4634
Practice Address - Country:US
Practice Address - Phone:910-343-1184
Practice Address - Fax:910-763-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1638251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408941Medicaid
NCHC1638OtherDHHS LICENSE NUMBER
NC6600573Medicaid
NC980504OtherDHHS FACILITY ID