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General NPI Number Information
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NPI Number | 1407878382
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL CARE HOME HEALTH SERVICES
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3126 MILTON RD SUITE 217
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City | CHARLOTTE
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State | NC
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Zip | 28215-3778
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Country | US
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Telephone | 704-536-7326
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Fax | 704-536-7147
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Provider Business Mailing Address
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Address Line | 3126 MILTON RD SUITE 217
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City | CHARLOTTE
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State | NC
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Zip | 28215-3778
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Country | US
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Telephone | 704-536-7326
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Fax | 704-536-7147
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. TERESIA M MEDLEY
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Credential | MSW
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Telephone | 704-536-7326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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