Healthcare Provider Details

I. General information

NPI: 1255912192
Provider Name (Legal Business Name): SKY HEART HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PRESTON EXECUTIVE DR STE 232
CARY NC
27513-8445
US

IV. Provider business mailing address

120 PRESTON EXECUTIVE DR STE 232
CARY NC
27513-8445
US

V. Phone/Fax

Practice location:
  • Phone: 919-802-7954
  • Fax: 919-300-5600
Mailing address:
  • Phone: 919-802-7954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. TASHA JONES
Title or Position: CEO
Credential: MBA, MHA
Phone: 919-753-7754