MEDICARE: HEBRON HOME 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	:	1619722022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEBRON HOME CARE LLC

Provider Business Mailing Address
First Line	:	1904 CARTIER RUBY LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-5097
Country	:	US
Telephone Number	:	301-956-4780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1904 CARTIER RUBY LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-5097
Country	:	US
Telephone Number	:	301-956-4780
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. HELEN OLAYINKA OGUNDIPE
Credential	:
Telephone Number	:	301-956-4780

Provider Enumeration Date	:	04/19/2024
Last Update Date	:	12/10/2025

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Directions to “HEBRON HOME CARE LLC ” Practice Location

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