Provider Demographics
NPI:1841516853
Name:CAROLINA REGIONAL HOME CARE, LLC
Entity type:Organization
Organization Name:CAROLINA REGIONAL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-255-6292
Mailing Address - Street 1:3924 SOUTH HOLDEN RD.
Mailing Address - Street 2:SUITE O
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8866
Mailing Address - Country:US
Mailing Address - Phone:336-255-6292
Mailing Address - Fax:336-292-0560
Practice Address - Street 1:3924 SOUTH HOLDEN RD.
Practice Address - Street 2:SUITE O
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8866
Practice Address - Country:US
Practice Address - Phone:336-255-6292
Practice Address - Fax:336-292-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3602163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty