Healthcare Provider Details

I. General information

NPI: 1962316166
Provider Name (Legal Business Name): ANJIE'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 SARDIS RD N STE 120B
CHARLOTTE NC
28227-7711
US

IV. Provider business mailing address

2101 SARDIS RD N STE 120B
CHARLOTTE NC
28227-7711
US

V. Phone/Fax

Practice location:
  • Phone: 704-649-3254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NINA FOMBUH
Title or Position: OWNER
Credential:
Phone: 508-840-2926