# WELL CARE HOME HEALTH OF THE TRIAD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952342784
- **Authorized official:** LISA MOORE (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (910) 362-9405

## Contact information

- **Practice address:** 146 DORNACH WAY STE 210, ADVANCE, NC 27006-7305
- **Practice address phone:** (336) 753-6200
- **Practice address fax:** (336) 751-9287
- **Mailing address:** 131 RACINE DR STE 201, WILMINGTON, NC 28403-8752
- **Mailing address phone:** (910) 362-9405
- **Mailing address fax:** (910) 202-1376

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 06/28/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3407051 | — | NC |