Healthcare Provider Details

I. General information

NPI: 1083440382
Provider Name (Legal Business Name): TOTAL HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N MANGUM ST STE 204
DURHAM NC
27701-2260
US

IV. Provider business mailing address

800 N MANGUM ST STE 204
DURHAM NC
27701-2260
US

V. Phone/Fax

Practice location:
  • Phone: 919-906-9140
  • 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 State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KELLEY DENICE FENNER
Title or Position: OWNER / DIRECTOR
Credential:
Phone: 919-906-9140