Provider Demographics
NPI:1578966271
Name:AT HOME SENIOR SERVICES
Entity Type:Organization
Organization Name:AT HOME SENIOR SERVICES
Other - Org Name:HOMECHOICE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-606-1739
Mailing Address - Street 1:750 COKESBURY RD
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-6527
Mailing Address - Country:US
Mailing Address - Phone:919-606-1739
Mailing Address - Fax:
Practice Address - Street 1:750 COKESBURY RD
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-6527
Practice Address - Country:US
Practice Address - Phone:919-606-1739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AT HOME SENIOR SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4687253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care