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General NPI Number Information
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NPI Number | 1861566903
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Entity Type | Organization
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Legal Business Name | THERACARE HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 101 S TRYON ST STE 2700
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City | CHARLOTTE
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State | NC
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Zip | 28280-0005
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Country | US
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Telephone | 704-671-8251
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S TRYON ST STE 2700
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City | CHARLOTTE
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State | NC
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Zip | 28280-0005
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Country | US
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Telephone | 704-671-8251
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEIRDRE BOOKER PIPPINS
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Credential |
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Telephone | 704-671-8251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC2834
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License Number State | NC
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