Healthcare Provider Details

I. General information

NPI: 1356178370
Provider Name (Legal Business Name): EXPRESSIONS OF LOVE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 JUDGES RD STE 11E
WILMINGTON NC
28405-3656
US

IV. Provider business mailing address

6006 DUXBURY CT
LELAND NC
28451-2116
US

V. Phone/Fax

Practice location:
  • Phone: 910-604-2257
  • Fax:
Mailing address:
  • Phone: 910-604-2257
  • 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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CHASITY TATE
Title or Position: OWNER
Credential:
Phone: 910-604-2257