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General NPI Number Information
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NPI Number | 1346854304
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Entity Type | Organization
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Legal Business Name | RAYNA'S HOME CARE, LLC
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Dates
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Enumeration Date | 09/06/2020
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 126 E GRANVILLE ST STE 1&2
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City | WINDSOR
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State | NC
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Zip | 27983-6754
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Country | US
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Telephone | 252-794-1213
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1158
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City | WINDSOR
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State | NC
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Zip | 27983-1158
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Country | US
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Telephone | 252-794-1213
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Fax |
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MRS. LATRAIKEYONNIA PRIDGEN EVANS
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Credential |
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Telephone | 252-794-1213
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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 |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State | NULL
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Taxonomy #6
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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 | NULL
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