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General NPI Number Information
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NPI Number | 1396233045
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Entity Type | Organization
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Legal Business Name | SHINING HEARTS HOME CARE OF NORTH CAROLINA LLC
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 2064 HUNTERS RIDGE DR
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City | MIDWAY PARK
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State | NC
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Zip | 28544-1609
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Country | US
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Telephone | 910-539-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 HUNTERS RIDGE DR
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City | MIDWAY PARK
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State | NC
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Zip | 28544-1609
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Country | US
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Telephone | 910-539-8800
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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 | HANNAH HUNTER
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Credential |
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Telephone | 910-939-0511
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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 | HC5010
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License Number State | NC
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