Healthcare Provider Details

I. General information

NPI: 1700233202
Provider Name (Legal Business Name): FRESH BEGINNINGS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 BREEZEWOOD AVE STE 101
FAYETTEVILLE NC
28303-5284
US

IV. Provider business mailing address

2935 BREEZEWOOD AVE STE 101
FAYETTEVILLE NC
28303-5284
US

V. Phone/Fax

Practice location:
  • Phone: 910-224-8908
  • Fax:
Mailing address:
  • Phone: 910-224-8908
  • 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 Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EMMITT HILL
Title or Position: OWNER
Credential:
Phone: 910-224-8908