Provider Demographics
NPI:1700101052
Name:PREFERRED HOME CARE, LLC
Entity Type:Organization
Organization Name:PREFERRED HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-398-2446
Mailing Address - Street 1:5237 ALBEMARLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2603
Mailing Address - Country:US
Mailing Address - Phone:704-532-4739
Mailing Address - Fax:704-532-4740
Practice Address - Street 1:5237 ALBEMARLE RD
Practice Address - Street 2:STE 207
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2603
Practice Address - Country:US
Practice Address - Phone:704-532-4739
Practice Address - Fax:704-532-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care