Provider Demographics
NPI:1750515797
Name:GENTLE TOUCH HOME CARE
Entity type:Organization
Organization Name:GENTLE TOUCH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-947-3805
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-0336
Mailing Address - Country:US
Mailing Address - Phone:910-947-3805
Mailing Address - Fax:910-947-3895
Practice Address - Street 1:703 S HORNER BLVD STE D
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4870
Practice Address - Country:US
Practice Address - Phone:919-777-0880
Practice Address - Fax:919-777-0890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENTLE TOUCH HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3546251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601792Medicaid