=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811700503
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARE-OLINA CARES HOME CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2025
-----------------------------------------------------
Last Update Date | 01/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 357 OLD HOLLOW RD STE 4
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27105-9684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-491-9006
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 357 OLD HOLLOW RD STE 4
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27105-9684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-491-9006
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MONTRAVON LATISE HERBIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-491-9006
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------