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General NPI Number Information
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NPI Number | 1922670850
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Entity Type | Organization
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Legal Business Name | CAROLINA CARE PROVIDERS INC
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 4826A WINDY HILL DRIVE
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City | RALEIGH
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State | NC
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Zip | 27609-2760
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Country | US
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Telephone | 919-724-6472
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Fax |
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Provider Business Mailing Address
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Address Line | 1856 AUSTIN RIDGE PKWY
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City | WAKE FOREST
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State | NC
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Zip | 27587-1899
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Country | US
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Telephone | 919-724-6472
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTIAN F FONEBI
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Credential |
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Telephone | 919-724-6472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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