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General NPI Number Information
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NPI Number | 1386653202
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Entity Type | Organization
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Legal Business Name | UPPER LEVEL HOME CARE & PERSONAL CARE SERVICES,LLC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3455 POLO RD STE 108
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4828
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Country | US
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Telephone | 336-659-1901
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Fax | 336-768-1860
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Provider Business Mailing Address
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Address Line | 3455 POLO RD STE 108
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4828
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Country | US
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Telephone | 336-659-1901
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Fax | 336-768-1860
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Authorized Official
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Title or Position | DIRECTOR
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Name | JESSIE KELLY-HOLMES
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Credential | RN,FNP
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Telephone | 336-659-1901
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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 | HC3179
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License Number State | NC
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