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General NPI Number Information
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NPI Number | 1528818713
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Entity Type | Organization
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Legal Business Name | NEW AGE HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 555 S MANGUM ST
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City | DURHAM
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State | NC
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Zip | 27701-4688
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Country | US
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Telephone | 919-339-5705
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 SUGAR HILL DR N
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City | CREEDMOOR
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State | NC
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Zip | 27522-7247
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Country | US
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Telephone | 919-339-5705
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR AND RN
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Name | TARRELLE C. READE
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Credential | RN
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Telephone | 919-339-5570
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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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