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Organization

CAROLINA LIVING HOME CARE AGENCY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CYNTHIA LOVELLE NICKELSON (OWNER/OPERATOR)
(910) 649-7359
Entity
Organization

Contact information

Practice address
575 MAIN STREET, FAIR BLUFF, NC 28439-9601
(910) 649-7359
Mailing address
263 MASON LN, CHADBOURN, NC 28431-7147
(910) 649-7359

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4178
NC

Other

Enumeration date
09/23/2010
Last updated
09/23/2010
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