Provider Demographics
NPI:1598469512
Name:COBB'S ENTERPRISE HOME CARE LLC
Entity Type:Organization
Organization Name:COBB'S ENTERPRISE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:984-204-0400
Mailing Address - Street 1:PO BOX 574
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-0574
Mailing Address - Country:US
Mailing Address - Phone:984-204-0400
Mailing Address - Fax:
Practice Address - Street 1:1341 NEW HILL RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6102
Practice Address - Country:US
Practice Address - Phone:984-204-4000
Practice Address - Fax:984-204-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care