Provider Demographics
NPI:1659641587
Name:T&C& ASSOCIATES HOME CARE AGENCEY
Entity Type:Organization
Organization Name:T&C& ASSOCIATES HOME CARE AGENCEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-224-0119
Mailing Address - Street 1:4542 RAEFORD RD
Mailing Address - Street 2:201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3207
Mailing Address - Country:US
Mailing Address - Phone:910-224-0119
Mailing Address - Fax:910-401-1265
Practice Address - Street 1:201 S. MCPHERSON CHURCH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4974
Practice Address - Country:US
Practice Address - Phone:910-237-5042
Practice Address - Fax:910-339-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3915251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health