Healthcare Provider Details

I. General information

NPI: 1083237309
Provider Name (Legal Business Name): W3 CARE HOME HEALTH ASSISTANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 WIND CHIME CT
RALEIGH NC
27615-6433
US

IV. Provider business mailing address

656 HAY RIVER ST
GARNER NC
27529-6209
US

V. Phone/Fax

Practice location:
  • Phone: 919-906-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: TASHE HOUSE
Title or Position: OWNER
Credential:
Phone: 919-906-4810