Healthcare Provider Details

I. General information

NPI: 1568101772
Provider Name (Legal Business Name): AFFIRM CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2022
Last Update Date: 06/04/2022
Certification Date: 06/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 MIDTOWN PL STE 125
RALEIGH NC
27609-1300
US

IV. Provider business mailing address

1604 CASCADE FALLS LN
WENDELL NC
27591-6879
US

V. Phone/Fax

Practice location:
  • Phone: 919-925-4440
  • Fax:
Mailing address:
  • Phone: 252-363-4535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: LACRYSHA EDMUNDSON
Title or Position: OWNER
Credential: RN
Phone: 252-363-4535