Provider Demographics
NPI:1659433910
Name:BANALTRUM PRIVATE DUTY CAREGIVERS, LTD
Entity Type:Organization
Organization Name:BANALTRUM PRIVATE DUTY CAREGIVERS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, AGENCY DIR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-251-0034
Mailing Address - Street 1:33 MINERAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1761
Mailing Address - Country:US
Mailing Address - Phone:828-251-0034
Mailing Address - Fax:828-251-0001
Practice Address - Street 1:33 MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1761
Practice Address - Country:US
Practice Address - Phone:828-251-0034
Practice Address - Fax:828-251-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1301251E00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC600098921Medicaid
NC6600382Medicaid
NC3408632Medicaid