Provider Demographics
NPI:1962025494
Name:HOME SWEET HOME 1
Entity Type:Organization
Organization Name:HOME SWEET HOME 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GARNETTA
Authorized Official - Middle Name:ENOCH
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-263-6860
Mailing Address - Street 1:PO BOX 2554
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-2554
Mailing Address - Country:US
Mailing Address - Phone:336-263-6860
Mailing Address - Fax:336-652-9009
Practice Address - Street 1:914 DIXIE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-6620
Practice Address - Country:US
Practice Address - Phone:336-263-6860
Practice Address - Fax:336-652-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health