Healthcare Provider Details

I. General information

NPI: 1497996367
Provider Name (Legal Business Name): IN HIS CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 OLD REDBUD DR
GASTONIA NC
28056-9284
US

IV. Provider business mailing address

3518 OLD REDBUD DR
GASTONIA NC
28056-9284
US

V. Phone/Fax

Practice location:
  • Phone: 704-864-5500
  • Fax: 704-864-5565
Mailing address:
  • Phone: 704-864-5500
  • Fax: 704-864-5565

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHC3787
License Number StateNC

VIII. Authorized Official

Name: MR. ROY B. GOFORTH III
Title or Position: PRESIDENT
Credential:
Phone: 704-864-5500