Organization
AVODAH CARE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD LILLY (DIRECTOR)
(704) 305-8171
Entity
Organization
Contact information
Practice address
1811 SARDIS RD N, CHARLOTTE, NC 28270-1426
(704) 305-8171
Mailing address
8920 LAWYERS RD # 691672, MINT HILL, NC 28227-9498
(704) 305-8171
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5531
NC DHSR HOME CARE LICENSE
NC
Enumeration date
10/01/2020
Last updated
10/03/2020
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