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NPI Code Detail

MEDICARE: TRANSFORMATIVE HOME CARE, LLC

MEDICARE: TRANSFORMATIVE 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1659227551
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSFORMATIVE HOME CARE, LLC
Provider Business Mailing Address
First Line : 115 E MAIN ST STE 17
Second Line :
City : WILLIAMSTON
State : NC
Zip : 27892-2482
Country : US
Telephone Number : 252-493-1860
Fax Number : 252-802-4348
Provider Business Practice Location Address
First Line : 115 E MAIN ST STE 17
Second Line :
City : WILLIAMSTON
State : NC
Zip : 27892-2482
Country : US
Telephone Number : 252-493-1860
Fax Number : 252-802-4348
Authorized Official
Title or Position : OWNER
Name : LATRISH GODDARD
Credential :
Telephone Number : 252-493-1860
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “TRANSFORMATIVE HOME CARE, LLC ” Practice Location

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