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General NPI Number Information
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NPI Number | 1366369746
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Entity Type | Organization
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Legal Business Name | LUMBEE ANGELS 575 HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 621 UNION CHAPEL RD STE B
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City | PEMBROKE
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State | NC
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Zip | 28372-7142
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Country | US
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Telephone | 910-775-9255
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Fax | 910-775-9257
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Provider Business Mailing Address
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Address Line | 621 UNION CHAPEL RD STE B
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City | PEMBROKE
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State | NC
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Zip | 28372-7142
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Country | US
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Telephone | 910-775-9255
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Fax | 910-775-9257
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Authorized Official
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Title or Position | CEO AND FOUNDER
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Name | CARITA JACOBS
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Credential |
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Telephone | 910-775-9255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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