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General NPI Number Information
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NPI Number | 1629865951
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Entity Type | Organization
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Legal Business Name | SHAWN'S HOME CARE LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 9310 HWY 130 BYPASS
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City | FAIRMONT
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State | NC
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Zip | 28340
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Country | US
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Telephone | 910-736-0607
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Fax |
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Provider Business Mailing Address
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Address Line | 9310 HWY 130 BYPASS
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City | FAIRMONT
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State | NC
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Zip | 28340
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Country | US
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Telephone | 910-736-0607
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL ADDICTION SPECIAL
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Name | SHAROLYN RENAE CAMPBELL
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Credential | LCAS-A
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Telephone | 910-280-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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