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General NPI Number Information
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NPI Number | 1194159640
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Entity Type | Organization
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Legal Business Name | WISEMINDS PERSONAL SERVICE AGENCY
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Dates
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Enumeration Date | 09/01/2013
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Last Update Date | 09/01/2013
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Provider Practice Location Address
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Address Line | 7200 SHELLBURNE DR
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City | RALEIGH
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State | NC
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Zip | 27612-2480
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Country | US
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Telephone | 317-397-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 SHELLBURNE DR
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City | RALEIGH
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State | NC
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Zip | 27612-2480
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Country | US
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Telephone | 317-397-4867
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIANNA L FOSTER
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Credential |
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Telephone | 317-397-4867
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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