=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447123427
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HALL HOME CARE SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2025
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3033 WOODS WALK WAY
-----------------------------------------------------
City | ROCKY MOUNT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27804-7466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-440-7894
-----------------------------------------------------
Fax | 919-440-7894
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3033 WOODS WALK WAY
-----------------------------------------------------
City | ROCKY MOUNT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27804-7466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-440-7894
-----------------------------------------------------
Fax | 919-440-7894
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AGENCY DIRECTOR
-----------------------------------------------------
Name | LAKISHA JUANITA HALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 919-440-7894
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------