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General NPI Number Information
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NPI Number | 1477693810
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Entity Type | Organization
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Legal Business Name | AT HOME PERSONAL CARE SERVICES,INC. OF NORTH CAROLINA
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 204 E ARLINGTON BLVD SUITE M
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City | GREENVILLE
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State | NC
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Zip | 27858-5022
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Country | US
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Telephone | 252-321-9300
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Fax | 252-321-9390
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Provider Business Mailing Address
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Address Line | 204 E ARLINGTON BLVD SUITE M
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City | GREENVILLE
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State | NC
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Zip | 27858-5022
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Country | US
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Telephone | 252-321-9300
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Fax | 252-321-9390
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Authorized Official
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Title or Position | OWNER
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Name | REGENIA LYNELLE GILLIAM
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Credential | RN
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Telephone | 252-321-9300
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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 | HC3608
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC2818
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License Number State | NC
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