Healthcare Provider Details

I. General information

NPI: 1639772361
Provider Name (Legal Business Name): HEMERA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 SUMMERHILL DR
CHARLOTTE NC
28212-7137
US

IV. Provider business mailing address

301 E JOHN ST # 2817
MATTHEWS NC
28105-4837
US

V. Phone/Fax

Practice location:
  • Phone: 575-495-3892
  • Fax:
Mailing address:
  • Phone: 704-268-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON LAMAR CALLENDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 575-495-3892