MEDICARE: IN TOUCH COMPANION CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386934776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN TOUCH COMPANION CARE LLC

Provider Business Mailing Address
First Line	:	3020 PROSPERITY CHURCH RD STE I
Second Line	:	407
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-8100
Country	:	US
Telephone Number	:	980-253-2300
Fax Number	:	980-253-2300

Provider Business Practice Location Address
First Line	:	3020 PROSPERITY CHURCH RD STE I
Second Line	:	407
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-8100
Country	:	US
Telephone Number	:	980-253-2300
Fax Number	:	980-253-2300

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LORENZO TERRENCE HILLS
Credential	:
Telephone Number	:	980-253-2300

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	04/19/2011

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