Provider Demographics
NPI:1639209216
Name:HEALTHCARE ONE, INC.
Entity Type:Organization
Organization Name:HEALTHCARE ONE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LATONZA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-201-4833
Mailing Address - Street 1:1503 ED COOK RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6156
Mailing Address - Country:US
Mailing Address - Phone:919-201-4833
Mailing Address - Fax:919-957-8348
Practice Address - Street 1:3805 UNIVERSITY DR
Practice Address - Street 2:SUITE- E
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6206
Practice Address - Country:US
Practice Address - Phone:919-201-4833
Practice Address - Fax:919-957-8348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3357251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601481Medicaid