Healthcare Provider Details

I. General information

NPI: 1063163178
Provider Name (Legal Business Name): HOMETOWN CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 02/15/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 S. CRIM AVE
BELINGTON WV
26250-8345
US

IV. Provider business mailing address

PO BOX 92
BELINGTON WV
26250-0092
US

V. Phone/Fax

Practice location:
  • Phone: 304-823-0223
  • Fax:
Mailing address:
  • Phone: 304-823-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN ANN PHILLIPS
Title or Position: DIRECTOR
Credential:
Phone: 304-823-0223