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NPI Code Detail

MEDICARE: AUDREY'S CARE AGENCY

MEDICARE: AUDREY'S CARE AGENCY
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
1251V00000XVoluntary or Charitable Agency
2251B00000XCase Management Agency
3251C00000XDevelopmentally Disabled Services Day Training Agency
4251S00000XCommunity/Behavioral Health Agency
5332U00000XHome Delivered Meals
6343800000XSecured Medical Transport (VAN)
7251E00000XHome Health Agency

General Provider Information

NPI Number : 1427838390
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUDREY'S CARE AGENCY
Provider Business Mailing Address
First Line : 5004 SAM RHYNE CT
Second Line :
City : DALLAS
State : NC
Zip : 28034-6400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5004 SAM RHYNE CT
Second Line :
City : DALLAS
State : NC
Zip : 28034-6400
Country : US
Telephone Number : 704-912-9561
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHANARA MINTZ
Credential :
Telephone Number : 704-912-9561
Provider Enumeration Date : 09/29/2023
Last Update Date : 09/29/2023

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Directions to “AUDREY'S CARE AGENCY ” Practice Location

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