MEDICARE: OVERCOMING HOME HEALTH CARE AGENCY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	251B00000X	Case Management Agency
3	251G00000X	Community Based Hospice Care Agency
4	251J00000X	Nursing Care Agency
5	251V00000X	Voluntary or Charitable Agency
6	253Z00000X	In Home Supportive Care Agency
7	261QM0850X	Adult Mental Health Clinic/Center
8	261QM0855X	Adolescent and Children Mental Health Clinic/Center
9	332U00000X	Home Delivered Meals
10	347C00000X	Private Vehicle
11	385H00000X	Respite Care
12	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1164073425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVERCOMING HOME HEALTH CARE AGENCY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 144
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27588-0144
Country	:	US
Telephone Number	:	252-425-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	4926 WINDY HILL DR STE A
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5182
Country	:	US
Telephone Number	:	255-425-5558
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTO/ OWNER
Name	:	BRENDA G JONES
Credential	:
Telephone Number	:	252-425-5558

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	09/26/2019

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