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General NPI Number Information
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NPI Number | 1700289014
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Entity Type | Organization
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Legal Business Name | AT HOME SENIOR SERVICES
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 2317 VERDANT CT
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City | WAKE FOREST
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State | NC
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Zip | 27587-3407
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Country | US
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Telephone | 919-606-1739
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Fax |
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Provider Business Mailing Address
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Address Line | 2317 VERDANT CT
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City | WAKE FOREST
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State | NC
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Zip | 27587-3407
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Country | US
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Telephone | 919-606-1739
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILLIP MORRIS
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Credential |
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Telephone | 919-606-1739
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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 | HC4685
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License Number State | NC
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