Provider Demographics
NPI:1629559968
Name:HOMECARE MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:HOMECARE MANAGEMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOONTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-754-3665
Mailing Address - Street 1:315 WILKESBORO BLVD NE STE 2A
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4498
Mailing Address - Country:US
Mailing Address - Phone:828-754-3665
Mailing Address - Fax:828-757-3195
Practice Address - Street 1:2818 QUEEN CITY DR STE E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-2736
Practice Address - Country:US
Practice Address - Phone:704-917-0230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care