Healthcare Provider Details

I. General information

NPI: 1346043189
Provider Name (Legal Business Name): THE CAREGIVERS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 N POINT BLVD STE J
WINSTON SALEM NC
27106-3244
US

IV. Provider business mailing address

111 S MAIN ST # PO6552
MOUNT AIRY NC
27030-4045
US

V. Phone/Fax

Practice location:
  • Phone: 336-590-6352
  • Fax:
Mailing address:
  • Phone: 336-590-6352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TREVON M SIMMONS
Title or Position: ADMIN
Credential:
Phone: 336-590-6352