Provider Demographics
NPI:1376694091
Name:HOMECARE FOR THE CAROLINAS
Entity type:Organization
Organization Name:HOMECARE FOR THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-335-8488
Mailing Address - Street 1:13048 ODELL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4388
Mailing Address - Country:US
Mailing Address - Phone:704-724-7041
Mailing Address - Fax:
Practice Address - Street 1:4301 MORRIS PARK DR STE 14
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-8253
Practice Address - Country:US
Practice Address - Phone:704-335-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE FOR THE CAROLINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601599Medicaid