1629494406 NPI number — CARING HANDS AND SUPPLEMENTARY ENRICHMENT EDUCATION, LLC

Table of content: (NPI 1629494406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629494406 NPI number — CARING HANDS AND SUPPLEMENTARY ENRICHMENT EDUCATION, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING HANDS AND SUPPLEMENTARY ENRICHMENT EDUCATION, LLC
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:
1629494406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2216 S MIAMI BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27703-6281
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-519-4985
Provider Business Mailing Address Fax Number:
919-479-5566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1315 RIPLEY ST
Provider Second Line Business Practice Location Address:
APT. B
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27707-1181
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-479-6806
Provider Business Practice Location Address Fax Number:
919-479-5566
Provider Enumeration Date:
03/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HINTON
Authorized Official First Name:
LUCIA
Authorized Official Middle Name:
P
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
919-519-4985

Provider Taxonomy Codes

  • Taxonomy code: 385HR2060X , with the licence number:  3418282 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: 3418282 , 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)

  • Identifier: 3418282 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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