Healthcare Provider Details
I. General information
NPI: 1023041837
Provider Name (Legal Business Name): TOTAL CARE HOME HEALTH OF LOUISBURG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
74 WHEATON AVE
YOUNGSVILLE NC
27596-8691
US
IV. Provider business mailing address
6330 SPRINT PKWY STE 300
OVERLAND PARK KS
66211-1157
US
V. Phone/Fax
- Phone: 919-554-2279
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
W
NICHOLS
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 913-814-2077