Healthcare Provider Details

I. General information

NPI: 1144538851
Provider Name (Legal Business Name): A FAMILY'S CHOICE HOME & HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 POPLARWOOD CT SUITE 114
RALEIGH NC
27604-1009
US

IV. Provider business mailing address

3117 POPLARWOOD CT SUITE 114
RALEIGH NC
27604-1009
US

V. Phone/Fax

Practice location:
  • Phone: 919-809-7213
  • Fax: 919-878-6770
Mailing address:
  • Phone: 919-809-7213
  • Fax: 919-878-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC4171
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC4171
License Number StateNC

VIII. Authorized Official

Name: MISS DANIEAL AVERY
Title or Position: ADMINISTRATOR
Credential:
Phone: 919-809-7213