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General NPI Number Information
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NPI Number | 1629559968
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Entity Type | Organization
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Legal Business Name | HOMECARE MANAGEMENT CORPORATION
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 2818 QUEEN CITY DR STE E
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City | CHARLOTTE
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State | NC
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Zip | 28208-2736
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Country | US
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Telephone | 704-917-0230
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Fax |
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Provider Business Mailing Address
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Address Line | 315 WILKESBORO BLVD NE STE 2A
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City | LENOIR
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State | NC
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Zip | 28645-4498
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Country | US
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Telephone | 828-754-3665
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Fax | 828-757-3195
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Authorized Official
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Title or Position | CFO
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Name | MARLA KOONTZ
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Credential |
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Telephone | 828-754-3665
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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