Provider Demographics
NPI:1750759718
Name:PERSONAL CARE GIVERS OF AMERICA
Entity type:Organization
Organization Name:PERSONAL CARE GIVERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-747-0565
Mailing Address - Street 1:4443 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2453
Mailing Address - Country:US
Mailing Address - Phone:910-747-0565
Mailing Address - Fax:
Practice Address - Street 1:4443 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2453
Practice Address - Country:US
Practice Address - Phone:910-747-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC385HR2065X, 320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child