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General NPI Number Information
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NPI Number | 1356530026
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Entity Type | Organization
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Legal Business Name | NATIVE ANGELS HOME CARE AGENCY INC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 113B WEST BROAD ST
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-9005
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Country | US
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Telephone | 910-862-3971
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Fax | 910-862-8467
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Provider Business Mailing Address
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Address Line | 201 EAST LIVERMORE DR
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City | PEMBROKE
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State | NC
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Zip | 28372-7322
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Country | US
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Telephone | 910-735-1541
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Fax | 910-735-1550
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Authorized Official
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Title or Position | CEO
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Name | MRS. BOBBIE JACOBS-GHAFFAR
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Credential |
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Telephone | 910-735-1541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HC3488
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License Number State | NC
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