Provider Demographics
NPI:1831463207
Name:MONAE'S HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:MONAE'S HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PEARSALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-453-3190
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-0038
Mailing Address - Country:US
Mailing Address - Phone:252-220-0141
Mailing Address - Fax:
Practice Address - Street 1:218 SOLLIE AYSCUE RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-9138
Practice Address - Country:US
Practice Address - Phone:252-220-0141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4525253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care