MEDICARE: HOME HEALTH ENTERPRISES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC3545	NC

General Provider Information

NPI Number	:	1205998226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH ENTERPRISES, INC

Provider Business Mailing Address
First Line	:	834 TYVOLA RD
Second Line	:	STE 116
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-3598
Country	:	US
Telephone Number	:	704-529-2682
Fax Number	:	704-529-2685

Provider Business Practice Location Address
First Line	:	834 TYVOLA RD
Second Line	:	STE 116
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-3598
Country	:	US
Telephone Number	:	704-529-2682
Fax Number	:	704-529-2685

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	MISS MONTOYA M CHRISTIAN-BOYD
Credential	:
Telephone Number	:	704-529-2682

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	10/05/2010

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