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General NPI Number Information
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NPI Number | 1215578984
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Entity Type | Organization
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Legal Business Name | FENOMINAL HOME CARE INC.
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 160 CHARLOTTE AVE
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City | SANFORD
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State | NC
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Zip | 27330-4318
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Country | US
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Telephone | 919-842-3330
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Fax | 919-292-1944
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Provider Business Mailing Address
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Address Line | 4302 TIMBERBROOKE DR APT 1D
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City | GREENSBORO
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State | NC
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Zip | 27409-9266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. FELICIA ALSTON
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Credential |
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Telephone | 919-842-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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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