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General NPI Number Information
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NPI Number | 1780086173
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Entity Type | Organization
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Legal Business Name | HOMEBRIDGE HEALTH CARE
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 11279 DEEP BRANCH RD
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City | MAXTON
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State | NC
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Zip | 28364-8958
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Country | US
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Telephone | 910-827-5884
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Fax |
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Provider Business Mailing Address
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Address Line | 11279 DEEP BRANCH RD
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City | MAXTON
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State | NC
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Zip | 28364-8958
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Country | US
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Telephone | 910-827-5884
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Fax |
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Authorized Official
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Title or Position | BILLING AGENT
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Name | CRYSTAL LOCKLEAR
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Credential |
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Telephone | 910-827-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NC
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