Healthcare Provider Details

I. General information

NPI: 1073184867
Provider Name (Legal Business Name): ADVANCED CASE MANAGEMENT AND HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 CASTLE ST STE A
WILMINGTON NC
28401-5300
US

IV. Provider business mailing address

819 CASTLE ST STE A
WILMINGTON NC
28401-5300
US

V. Phone/Fax

Practice location:
  • Phone: 910-899-9124
  • Fax:
Mailing address:
  • Phone: 910-297-7329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE ROBINSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 910-524-9360