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General NPI Number Information
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NPI Number | 1518635341
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Entity Type | Organization
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Legal Business Name | MODERN HOME CARE
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 10130 PERIMETER PKWY STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28216-0197
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Country | US
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Telephone | 704-608-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 10130 PERIMETER PKWY STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28216-0197
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Country | US
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Telephone | 704-608-9898
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Fax |
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Authorized Official
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Title or Position | CHIEF NURSING OFFICER
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Name | SHEILA RN STEVENSON
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Credential | RN, MHA
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Telephone | 704-608-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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