Provider Demographics
NPI:1831243039
Name:CENTERPEACE HOME HEALTHCARE & COMPANION SERVICES, LLC
Entity type:Organization
Organization Name:CENTERPEACE HOME HEALTHCARE & COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-567-8200
Mailing Address - Street 1:521 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1707
Mailing Address - Country:US
Mailing Address - Phone:919-567-8200
Mailing Address - Fax:919-567-8201
Practice Address - Street 1:521 BROAD ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1707
Practice Address - Country:US
Practice Address - Phone:919-567-8200
Practice Address - Fax:919-567-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418247Medicaid