Provider Demographics
NPI:1760812911
Name:EBBENSTONE SENIOR CARE
Entity Type:Organization
Organization Name:EBBENSTONE SENIOR CARE
Other - Org Name:CARING SENIOR SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-605-9296
Mailing Address - Street 1:5630 SIX FORKS RD
Mailing Address - Street 2:STE 203
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3898
Mailing Address - Country:US
Mailing Address - Phone:919-386-0522
Mailing Address - Fax:800-536-7056
Practice Address - Street 1:5630 SIX FORKS RD
Practice Address - Street 2:STE 203
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3898
Practice Address - Country:US
Practice Address - Phone:919-386-0522
Practice Address - Fax:800-536-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-24
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3073253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care