Healthcare Provider Details

I. General information

NPI: 1285974113
Provider Name (Legal Business Name): HELPING MANY LIVES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14627 US HIGHWAY 64
WILLIAMSTON NC
27892-8638
US

IV. Provider business mailing address

14627 US HIGHWAY 64
WILLIAMSTON NC
27892-8638
US

V. Phone/Fax

Practice location:
  • Phone: 252-378-7436
  • Fax:
Mailing address:
  • Phone: 252-217-9717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC4836
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License NumberHC4836
License Number StateNC

VIII. Authorized Official

Name: MS. KENYA L RODGERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: BS, QMHP, CSAC-R
Phone: 252-378-7436