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General NPI Number Information
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NPI Number | 1336444561
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Entity Type | Organization
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Legal Business Name | NEW INFINITI HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 6604 ROBERTA RD
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City | HARRISBURG
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State | NC
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Zip | 28075-9532
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Country | US
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Telephone | 704-644-2550
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Fax | 704-644-2553
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Provider Business Mailing Address
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Address Line | PO BOX 43148
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City | CHARLOTTE
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State | NC
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Zip | 28215-0019
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Country | US
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Telephone | 704-644-2550
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Fax | 704-644-2553
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Authorized Official
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Title or Position | OWNER
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Name | CRYSTAL N CAGLER
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Credential |
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Telephone | 704-615-5252
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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