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Organization
A FULFILLED VISION HOME HEALTH CARE
Active
Organization
A FULFILLED VISION HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANATA CRAWFORD (CEO)
(704) 691-7540
Entity
Organization
Contact information
Practice address
128 E GARRISON BLVD STE B, GASTONIA, NC 28054-0421
(704) 884-1976
(704) 691-7543
Mailing address
128 E GARRISON BLVD STE B, GASTONIA, NC 28054-0421
(704) 884-1976
(704) 691-7543
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3836
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720217169
—
NC
Enumeration date
09/08/2010
Last updated
09/08/2010
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