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Organization
WHITE SWAN HOME HEALTH CARE, LLC
Active
Organization
WHITE SWAN HOME HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAUN LEE (OWNER)
(954) 479-9856
Entity
Organization
Contact information
Practice address
120 N BROAD STREET, 1-A, ANGIER, NC 27501-0000
(919) 799-2019
Mailing address
4173 HEARTHSIDE DRIVE, 104, WILMINGTON, NC 28412-8335
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC4238
NC
253Z00000X
In Home Supportive Care Agency
Primary
HC4238
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC4238
NC DHHS
NC
Enumeration date
02/15/2013
Last updated
06/19/2013
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