1205998226 NPI number — HOME HEALTH ENTERPRISES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205998226 NPI number — HOME HEALTH ENTERPRISES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH ENTERPRISES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205998226
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
834 TYVOLA RD
Provider Second Line Business Mailing Address:
STE 116
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28217-3598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-529-2682
Provider Business Mailing Address Fax Number:
704-529-2685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
834 TYVOLA RD
Provider Second Line Business Practice Location Address:
STE 116
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28217-3598
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-529-2682
Provider Business Practice Location Address Fax Number:
704-529-2685
Provider Enumeration Date:
12/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHRISTIAN-BOYD
Authorized Official First Name:
MONTOYA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
AGENCY DIRECTOR
Authorized Official Telephone Number:
704-529-2682

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC3545 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)