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General NPI Number Information
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NPI Number | 1871771477
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Entity Type | Organization
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Legal Business Name | NATIVE ANGELS HOME CARE AGENCY INC
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 2008 LITHO PL
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-2518
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Country | US
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Telephone | 910-483-1357
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Fax | 910-483-8609
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Provider Business Mailing Address
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Address Line | 4701 FAYETTEVILLE RD SUITE C
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City | LUMBERTON
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State | NC
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Zip | 28358-2622
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Country | US
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Telephone | 910-735-1547
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Fax | 910-735-1550
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. BOBBIE JACOBS-GHAFFAR
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Credential |
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Telephone | 910-735-1541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HC 3489
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License Number State | NC
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