Healthcare Provider Details

I. General information

NPI: 1750759718
Provider Name (Legal Business Name): PERSONAL CARE GIVERS OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4443 CUMBERLAND RD
FAYETTEVILLE NC
28306-2453
US

IV. Provider business mailing address

4443 CUMBERLAND RD
FAYETTEVILLE NC
28306-2453
US

V. Phone/Fax

Practice location:
  • Phone: 910-747-0565
  • Fax:
Mailing address:
  • Phone: 910-747-0565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number StateNC

VIII. Authorized Official

Name: AUSTIN J. HAWKINS
Title or Position: PRESIDENT
Credential:
Phone: 910-747-0565