Provider Demographics
NPI:1942717442
Name:JOURNEY HOMECARE SERVICES
Entity Type:Organization
Organization Name:JOURNEY HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-327-8080
Mailing Address - Street 1:1451 S ELM EUGENE ST # 1211
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-2200
Mailing Address - Country:US
Mailing Address - Phone:336-763-5055
Mailing Address - Fax:336-464-2333
Practice Address - Street 1:1451 S ELM EUGENE ST # 1211
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-2200
Practice Address - Country:US
Practice Address - Phone:336-763-5055
Practice Address - Fax:336-464-2333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOURNEY ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-05
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251F00000XAgenciesHome InfusionGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care