MEDICARE: HEALTH ASSURED HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134943699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH ASSURED HOME CARE LLC

Provider Business Mailing Address
First Line	:	3440 TORINGDON WAY STE 205
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3191
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 TORINGDON WAY STE 205
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3191
Country	:	US
Telephone Number	:	980-239-9535
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HINSENE SAMSON
Credential	:
Telephone Number	:	980-239-9535

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	11/12/2024

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Directions to “HEALTH ASSURED HOME CARE LLC ” Practice Location

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