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General NPI Number Information
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NPI Number | 1598120099
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Entity Type | Organization
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Legal Business Name | PRO CARE HOME CARE LLC
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 602 BESSEMER CITY RD
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City | GASTONIA
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State | NC
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Zip | 28052-1313
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Country | US
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Telephone | 704-706-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 W MAIN ST
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City | ALBEMARLE
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State | NC
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Zip | 28001-4537
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TIFFANY KENDALL
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Credential |
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Telephone | 704-706-7075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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