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General NPI Number Information
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NPI Number | 1679613087
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Entity Type | Organization
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Legal Business Name | STACIES PERSONAL CARE SERVICES INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 10 S MAIN ST UNIT B
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City | WEAVERVILLE
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State | NC
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Zip | 28787
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Country | US
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Telephone | 828-484-8440
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Fax | 828-848-8445
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Provider Business Mailing Address
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Address Line | 10 S MAIN ST UNIT B
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City | WEAVERVILLE
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State | NC
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Zip | 28787
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Country | US
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Telephone | 828-649-9014
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Fax | 828-649-3467
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Authorized Official
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Title or Position | PRESIDENT
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Name | STACIE WILSON
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Credential | R.N.
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Telephone | 828-649-9014
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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 | HC3184
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License Number State | NC
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