Healthcare Provider Details

I. General information

NPI: 1972670388
Provider Name (Legal Business Name): TANYA DANIELLA MELTON PERSONALCARESERVICES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 RED STONE CT
ROUGEMONT NC
27572-9407
US

IV. Provider business mailing address

988 RED STONE CT
ROUGEMONT NC
27572-9407
US

V. Phone/Fax

Practice location:
  • Phone: 919-641-5722
  • Fax: 800-693-5742
Mailing address:
  • Phone: 919-641-5722
  • Fax: 800-693-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberHC3519
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License NumberHC3519
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License NumberHC3519
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHC3519
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHC3519
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberHC3519
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License NumberHC3519
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberHC3519
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC3519
License Number StateNC
# 11
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License NumberHC3519
License Number StateNC
# 12
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberHC3519
License Number StateNC
# 13
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberHC3519
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: