Healthcare Provider Details

I. General information

NPI: 1497320741
Provider Name (Legal Business Name): DEVOTED HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/28/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CLARK PLZ
WARSAW NC
28398-1800
US

IV. Provider business mailing address

107 CLARK PLZ
WARSAW NC
28398-1800
US

V. Phone/Fax

Practice location:
  • Phone: 910-476-1257
  • Fax:
Mailing address:
  • Phone: 910-476-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. LUCIANE BARKSDALE
Title or Position: AGENCY DIRECTOR
Credential: DIRECTOR
Phone: 910-441-9629