=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497932990
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STANZELCO LLC DBA HOMEHELPERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2008
-----------------------------------------------------
Last Update Date | 12/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 311 WHITE ST
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28739-5239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-694-0000
-----------------------------------------------------
Fax | 828-694-0303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 WHITE ST
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28739-5239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-694-0000
-----------------------------------------------------
Fax | 828-694-0303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. STEPHEN MICHAEL EDWARDS
-----------------------------------------------------
Credential | MSW
-----------------------------------------------------
Telephone | 828-694-0000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | HC2081
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC2081
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------