Healthcare Provider Details

I. General information

NPI: 1023217270
Provider Name (Legal Business Name): DOVE PERSONAL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N QUEEN ST STE. 306
KINSTON NC
28501-4984
US

IV. Provider business mailing address

3900 BARRETT DR STE. 101
RALEIGH NC
27609-6641
US

V. Phone/Fax

Practice location:
  • Phone: 252-522-4676
  • Fax: 252-522-4355
Mailing address:
  • Phone: 919-786-4388
  • Fax: 919-786-4399

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NANETTE FLOYD PATTERSON
Title or Position: DIRECTOR/CEO
Credential: MA QP
Phone: 919-786-4388