Healthcare Provider Details

I. General information

NPI: 1194961037
Provider Name (Legal Business Name): ZONE FREE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2008
Last Update Date: 12/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 A HWY 74
WINGATE NC
28174
US

IV. Provider business mailing address

PO BOX 1114
WINGATE NC
28174-1114
US

V. Phone/Fax

Practice location:
  • Phone: 704-237-7119
  • Fax:
Mailing address:
  • Phone: 704-237-7119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELODY IRENE TAYLOR
Title or Position: OWNER
Credential:
Phone: 704-237-7119