Provider Demographics
NPI:1780267500
Name:C&S HOME CARE AGENCY, L.L.C.
Entity type:Organization
Organization Name:C&S HOME CARE AGENCY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-493-3096
Mailing Address - Street 1:6504 PEACEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2300
Mailing Address - Country:US
Mailing Address - Phone:704-493-3096
Mailing Address - Fax:704-626-3457
Practice Address - Street 1:6504 PEACEHAVEN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-2300
Practice Address - Country:US
Practice Address - Phone:704-493-3096
Practice Address - Fax:704-626-3457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1629662168Medicaid