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General NPI Number Information
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NPI Number | 1265616924
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Entity Type | Organization
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Legal Business Name | ENHANCING SPIRITS HOME CARE AGENCY
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 100 W 2ND ST
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City | LUMBERTON
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State | NC
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Zip | 28358-5610
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Country | US
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Telephone | 910-671-8128
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Fax | 910-671-8130
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Provider Business Mailing Address
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Address Line | 100 W 2ND ST
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City | LUMBERTON
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State | NC
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Zip | 28358-5610
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Country | US
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Telephone | 910-671-8128
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Fax | 910-671-8130
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LISA MARIE JACOBS
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Credential | RN
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Telephone | 910-671-8128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC3521
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License Number State | NC
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