Provider Demographics
NPI:1598840365
Name:UNIVERSAL SERVICES DBA REYNOLDS HOME CARE
Entity Type:Organization
Organization Name:UNIVERSAL SERVICES DBA REYNOLDS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-397-0091
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:SUITE 2501
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3836
Mailing Address - Country:US
Mailing Address - Phone:336-397-0091
Mailing Address - Fax:336-397-0097
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:SUITE 2501
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3836
Practice Address - Country:US
Practice Address - Phone:336-397-0091
Practice Address - Fax:336-397-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600857Medicaid