Healthcare Provider Details

I. General information

NPI: 1033614151
Provider Name (Legal Business Name): AVID HEALTH AT HOME NORTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 13TH ST SE
HICKORY NC
28602-4165
US

IV. Provider business mailing address

1508 MILITARY CUTOFF RD STE 304
WILMINGTON NC
28403-5730
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-9996
  • Fax: 910-343-0352
Mailing address:
  • Phone: 910-343-9996
  • Fax: 910-343-0352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LENTZ
Title or Position: CEO
Credential:
Phone: 910-728-4668