Provider Demographics
NPI:1972211597
Name:CONTESSA'S HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:CONTESSA'S HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONTESSA
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-543-6482
Mailing Address - Street 1:3404 BRISTLE CONE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-6503
Mailing Address - Country:US
Mailing Address - Phone:336-543-6482
Mailing Address - Fax:
Practice Address - Street 1:2783 NC HWY-68 S
Practice Address - Street 2:UNIT 118, SUITE-A
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265
Practice Address - Country:US
Practice Address - Phone:336-543-6482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC135606771Medicaid