Carolina Home Care,LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

HC4169 Issued in NC

Legal business name

CAROLINA HOME CARE,LLC

Practice address

105 East Broad Street
Elizabethtown, NC 28337

Phone

(910) 862-2600

Fax

(910) 862-8400

NPI assigned

Sep 14, 2010

Last updated

Sep 14, 2010By 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. Jacqueline Montress Stallworth

Title

President

Phone

(910) 242-2956

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1407164361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1165",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-2600",
            "fax_number": "910-862-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EAST BROAD STREET",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-2600",
            "fax_number": "910-862-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HOME CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MONTRESS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-242-2956",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC4169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.