Healthcare Provider Details

I. General information

NPI: 1477682243
Provider Name (Legal Business Name): NEIGHBORHOOD NURSES HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 N ROCKY RIVER RD
MONROE NC
28110-7961
US

IV. Provider business mailing address

1821 N ROCKY RIVER RD
MONROE NC
28110-7961
US

V. Phone/Fax

Practice location:
  • Phone: 704-292-1234
  • Fax: 704-292-1112
Mailing address:
  • Phone: 704-292-1234
  • Fax: 704-292-1112

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 NumberHC2239
License Number StateNC

VIII. Authorized Official

Name: MR. JOSEF MICHAEL PENNIGAR
Title or Position: VP
Credential:
Phone: 704-292-1234