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General NPI Number Information
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NPI Number | 1265145692
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Entity Type | Organization
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Legal Business Name | LONGLIVE HOME CARE NC
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Dates
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Enumeration Date | 12/30/2022
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 2500 REGENCY PKWY
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City | CARY
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State | NC
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Zip | 27518-8549
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Country | US
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Telephone | 703-942-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 10304 EATON PL STE 100
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City | FAIRFAX
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State | VA
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Zip | 22030-2221
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Country | US
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Telephone | 703-942-9400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHARON LEE
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Credential |
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Telephone | 571-623-0255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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