=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851913339
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2020
-----------------------------------------------------
Last Update Date | 05/07/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 TRINDALE RD UNIT D
-----------------------------------------------------
City | ARCHDALE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27263-3800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-404-9956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5205 SWITCHBACK DR
-----------------------------------------------------
City | HIGH POINT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27265-2933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-404-9956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. SHARIA SHONDALE COOPER
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 336-404-9956
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------