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General NPI Number Information
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NPI Number | 1215121256
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Entity Type | Organization
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Legal Business Name | ELDERCARE HOMECARE SERVICES, INC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 410 OBERLIN ROAD SUITE 301
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City | RALEIGH
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State | NC
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Zip | 27605-1352
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Country | US
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Telephone | 919-832-7500
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Fax | 919-832-7119
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Provider Business Mailing Address
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Address Line | 410 OBERLIN ROAD SUITE 301
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City | RALEIGH
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State | NC
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Zip | 27605-1352
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Country | US
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Telephone | 919-832-7500
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Fax | 919-832-7119
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. RUBY L DAVIS
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Credential |
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Telephone | 919-755-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | HC1823
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HC1823
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License Number State | NC
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