Provider Demographics
NPI:1790029130
Name:HOME CARE AGENCY OF NORTH CAROLINA, LLC
Entity Type:Organization
Organization Name:HOME CARE AGENCY OF NORTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HANIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:919-888-0654
Mailing Address - Street 1:14400 TWICKENHAM PL
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2471
Mailing Address - Country:US
Mailing Address - Phone:919-888-0654
Mailing Address - Fax:
Practice Address - Street 1:111 DENNIS DR STE 121
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6461
Practice Address - Country:US
Practice Address - Phone:919-888-0654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4625253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care