Provider Demographics
NPI:1821115148
Name:HOMECHOICE COMPANIONS LLC
Entity Type:Organization
Organization Name:HOMECHOICE COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-863-4167
Mailing Address - Street 1:2501 BLUE RIDGE RD. SUITE 150
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6479
Mailing Address - Country:US
Mailing Address - Phone:919-863-4167
Mailing Address - Fax:919-863-4158
Practice Address - Street 1:2501 BLUE RIDGE RD STE150
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6479
Practice Address - Country:US
Practice Address - Phone:919-863-4167
Practice Address - Fax:919-863-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601456Medicaid