Carolina Living Home Care Agency Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

HC4178 Issued in NC

Legal business name

CAROLINA LIVING HOME CARE AGENCY INC.

Practice address

575 Main Street
Fair Bluff, NC 28439-9601

Phone

(910) 649-7359

NPI assigned

Sep 23, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia Lovelle Nickelson

Title

Owner/Operator

Phone

(910) 649-7359

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1083922181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 MASON LN",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284317147",
            "telephone_number": "910-649-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MAIN STREET",
            "city": "FAIR BLUFF",
            "state": "NC",
            "postal_code": "284399601",
            "telephone_number": "910-649-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA LIVING HOME CARE AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "NICKELSON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "LOVELLE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "910-649-7359",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC4178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.