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NPI Code Detail

MEDICARE: CARDEA HEALTHCARE, LLC

MEDICARE: CARDEA HEALTHCARE, 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
1374U00000XHome Health AideHC4152NC
23747P1801XPersonal Care AttendantHC4152NC
33747A0650XAttendant Care ProviderHC4152NC
4253Z00000XIn Home Supportive Care AgencyHC4152NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306150040
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDEA HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 8801 FAST PARK DR
Second Line : SUITE 211
City : RALEIGH
State : NC
Zip : 27617-4852
Country : US
Telephone Number : 919-786-5052
Fax Number : 919-786-5067
Provider Business Practice Location Address
First Line : 8801 FAST PARK DR
Second Line : SUITE 211
City : RALEIGH
State : NC
Zip : 27617-4852
Country : US
Telephone Number : 919-786-5052
Fax Number : 919-786-5067
Authorized Official
Title or Position : AGENCY DIRECTOR
Name : MS. CAROL LEA CANELAS
Credential : RN, BSN, MA
Telephone Number : 919-786-5052
Provider Enumeration Date : 08/05/2010
Last Update Date : 03/04/2011

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Directions to “CARDEA HEALTHCARE, LLC ” Practice Location

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