Healthcare Provider Details

I. General information

NPI: 1275755316
Provider Name (Legal Business Name): CAROLINA STAFFING AND HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 UNIVERSITY DR SUITE D
DURHAM NC
27707-2658
US

IV. Provider business mailing address

3214 CHARLES B ROOT WYND SUITE 101
RALEIGH NC
27612-5440
US

V. Phone/Fax

Practice location:
  • Phone: 919-881-0277
  • Fax: 919-881-0278
Mailing address:
  • Phone: 919-881-0277
  • Fax: 919-881-0278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC2523
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberMHL-092-653
License Number StateNC

VIII. Authorized Official

Name: MR. ISRAEL UDOCHUKWU OJIMADU
Title or Position: ADMINISTRATOR
Credential:
Phone: 919-881-0277