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Organization
ISLAND HOME CARE, PLLC
Active
Organization
ISLAND HOME CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISLANDE MITIL RN (OWNER/DIRECTOR)
(919) 588-4435
Entity
Organization
Contact information
Practice address
5300 ATLANTIC AVE STE 106E, RALEIGH, NC 27609-1123
(919) 588-4435
Mailing address
PO BOX 98024, RALEIGH, NC 27624-8024
(919) 588-4435
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-388969
IRS
—
Enumeration date
04/24/2020
Last updated
04/24/2020
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