Provider Demographics
NPI:1912406208
Name:NO PLACE LIKE HOME SUPPORT CARE
Entity Type:Organization
Organization Name:NO PLACE LIKE HOME SUPPORT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASHONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-273-0425
Mailing Address - Street 1:8228 HORNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7362
Mailing Address - Country:US
Mailing Address - Phone:980-273-0425
Mailing Address - Fax:
Practice Address - Street 1:8228 HORNWOOD CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7362
Practice Address - Country:US
Practice Address - Phone:704-247-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty