Provider Demographics
NPI:1841838505
Name:DILACK HOME CARE AND NURSING SERVICES
Entity type:Organization
Organization Name:DILACK HOME CARE AND NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-953-5002
Mailing Address - Street 1:16508 NORTHCROSS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5081
Mailing Address - Country:US
Mailing Address - Phone:704-953-5002
Mailing Address - Fax:
Practice Address - Street 1:16508 NORTHCROSS DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5081
Practice Address - Country:US
Practice Address - Phone:704-953-5002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health