Healthcare Provider Details

I. General information

NPI: 1518517747
Provider Name (Legal Business Name): MS ENHANCEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N PERSON ST
RALEIGH NC
27604-1216
US

IV. Provider business mailing address

702 N PERSON ST
RALEIGH NC
27604-1216
US

V. Phone/Fax

Practice location:
  • Phone: 919-491-7586
  • Fax:
Mailing address:
  • Phone: 919-491-7586
  • Fax:

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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MATTIE STEVENSON
Title or Position: OWNER
Credential: MBA
Phone: 919-491-7586