Provider Demographics
NPI:1770221392
Name:WISE CHOICE TENDER LOVING CASRE
Entity Type:Organization
Organization Name:WISE CHOICE TENDER LOVING CASRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZELMA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-332-0021
Mailing Address - Street 1:7312 SHILLINGLAW CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-6254
Mailing Address - Country:US
Mailing Address - Phone:571-332-0021
Mailing Address - Fax:
Practice Address - Street 1:7312 SHILLINGLAW CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6254
Practice Address - Country:US
Practice Address - Phone:571-332-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty