Provider Demographics
NPI:1922248822
Name:CAROLINA STAFFING & HOME HEALTH CO,INC
Entity Type:Organization
Organization Name:CAROLINA STAFFING & HOME HEALTH CO,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:UDOCHUKWU
Authorized Official - Last Name:OJIMADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-881-0277
Mailing Address - Street 1:3510 UNIVERSITY DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2658
Mailing Address - Country:US
Mailing Address - Phone:919-881-0277
Mailing Address - Fax:919-881-0278
Practice Address - Street 1:3214 CHARLES B ROOT WYND
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5440
Practice Address - Country:US
Practice Address - Phone:919-881-0277
Practice Address - Fax:919-881-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092656251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409683Medicaid