MEDICARE: CARING HANDS AND SUPPLEMENTARY ENRICHMENT EDUCATION, LLC

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	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215369137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING HANDS AND SUPPLEMENTARY ENRICHMENT EDUCATION, LLC

Provider Business Mailing Address
First Line	:	3512 PINKHAM WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8322
Country	:	US
Telephone Number	:	919-479-6806
Fax Number	:	919-479-5566

Provider Business Practice Location Address
First Line	:	3512 PINKHAM WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8322
Country	:	US
Telephone Number	:	919-479-6806
Fax Number	:	919-479-5566

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. LUCIA P HINTON
Credential	:	MSA
Telephone Number	:	919-479-6806

Provider Enumeration Date	:	08/01/2013
Last Update Date	:	08/01/2013

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