Addae at Home Senior Services LLC

Key facts

NPI

1902571300

Entity type

Organization (NPI type 2)

Primary specialty

In Home Supportive Care Agency 253Z00000X

Legal business name

ADDAE AT HOME SENIOR SERVICES LLC

Practice address

2211 E Main St
Albemarle, NC 28001-8182

Phone

(910) 975-9674

NPI assigned

Aug 9, 2021

Organization subpart

No

Authorized official

Name

Ms. Carrie Nicole Ingram, RN

Title

Director

Phone

(910) 975-9674

National Provider Directory

Specialties & licenses

Addresses

Other names

• Addae At Home Senior Services LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 9, 2021.

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1902571300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 COLE RD",
            "city": "CANDOR",
            "state": "NC",
            "postal_code": "272299678",
            "telephone_number": "910-975-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E MAIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018182",
            "telephone_number": "910-975-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDAE AT HOME SENIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-975-9674",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addae At Home Senior Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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