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General NPI Number Information
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NPI Number | 1063537546
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Entity Type | Organization
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Legal Business Name | CAROLINA ANGELS HOME CARE INC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 756 TYVOLA RD STE 143
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City | CHARLOTTE
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State | NC
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Zip | 28217-8217
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Country | US
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Telephone | 704-523-1040
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Fax | 704-523-1080
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Provider Business Mailing Address
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Address Line | 756 TYVOLA RD STE 143
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City | CHARLOTTE
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State | NC
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Zip | 28217-8217
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Country | US
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Telephone | 704-523-1040
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Fax | 704-523-1080
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Authorized Official
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Title or Position | SERVICE SUPERVISOR
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Name | MRS. STEPHANIE RENEE BRATHWAITE
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Credential | RN
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Telephone | 704-523-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 193729
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 193728
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License Number State | NC
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