Provider Demographics
NPI:1851449086
Name:HENDRICK HOME CARE, LLC
Entity Type:Organization
Organization Name:HENDRICK HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DETRON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-661-6601
Mailing Address - Street 1:1800 CAMDEN RD
Mailing Address - Street 2:SUITE 107-227
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4690
Mailing Address - Country:US
Mailing Address - Phone:704-661-6601
Mailing Address - Fax:
Practice Address - Street 1:1800 CAMDEN RD
Practice Address - Street 2:SUITE 107-227
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4690
Practice Address - Country:US
Practice Address - Phone:704-661-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3623251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health