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General NPI Number Information
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NPI Number | 1104067362
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Entity Type | Organization
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Legal Business Name | STACIES PERSONAL CARE SERVICES, INC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 367 DELLWOOD RD
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3135
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Country | US
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Telephone | 828-452-6992
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | MARSHALL
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State | NC
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Zip | 28753-0067
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Country | US
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Telephone | 828-649-9014
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STACIE WILSON
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Credential |
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Telephone | 828-649-9014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC3788
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License Number State | NC
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