Mission Home Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC3146 Issued in NC

Legal business name

MISSION HOME HEALTHCARE, LLC

Practice address

3270 Martin L. King Dr.
Lumberton, NC 28358

Phone

(910) 671-6044

Fax

(910) 671-6286

NPI assigned

Mar 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Delores Ann McCoy

Title

Director

Phone

(910) 671-6044

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033236443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 MARTIN L. KING DRIVE",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-671-6044",
            "fax_number": "910-671-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 MARTIN L. KING DR.",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-671-6044",
            "fax_number": "910-671-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "DELORES",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-671-6044",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601377",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418079",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Miller, PTA
• Richard Miller
• Dennis D. Mims
• Mind Body Wellness Centre
• Mission Foot and Ankle, PLLC
• Tiara Marque Mitchell, LCSW-A
• Victoria Brooke Mitchell
• Chiranj Nishith Modi, MD
• Ishtiaque Hossain Mohiuddin
• Fasil Ferris Mohomed, MD

• Home Health Agency in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.