Healthcare Provider Details

I. General information

NPI: 1386359065
Provider Name (Legal Business Name): FAMILY ORIENTED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 HILLOCK DR UNIT E
RALEIGH NC
27612-4037
US

IV. Provider business mailing address

5540 CENTERVIEW DR STE 204
RALEIGH NC
27606-8012
US

V. Phone/Fax

Practice location:
  • Phone: 919-264-1368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MONESHA HOLLIDAY
Title or Position: CEO/MANAGER
Credential: BA
Phone: 919-264-1368