Provider Demographics
NPI:1013605476
Name:CAREBRIDGE HOMECARE AGENCY
Entity Type:Organization
Organization Name:CAREBRIDGE HOMECARE AGENCY
Other - Org Name:CAREBRIDGE MEDICAL STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYISIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-405-4946
Mailing Address - Street 1:2505 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4919
Mailing Address - Country:US
Mailing Address - Phone:336-907-3030
Mailing Address - Fax:336-676-4045
Practice Address - Street 1:2505 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4919
Practice Address - Country:US
Practice Address - Phone:336-907-3030
Practice Address - Fax:336-676-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care