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General NPI Number Information
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NPI Number | 1962025494
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Entity Type | Organization
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Legal Business Name | HOME SWEET HOME 1
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 914 DIXIE ST
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City | BURLINGTON
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State | NC
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Zip | 27217-6620
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Country | US
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Telephone | 336-263-6860
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Fax | 336-652-9009
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Provider Business Mailing Address
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Address Line | PO BOX 2554
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City | BURLINGTON
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State | NC
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Zip | 27216-2554
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Country | US
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Telephone | 336-263-6860
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Fax | 336-652-9009
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Authorized Official
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Title or Position | MANAGER
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Name | GARNETTA ENOCH MCADAMS
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Credential |
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Telephone | 336-263-6860
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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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