Organization
PASSIONATE C.N.A HOME CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NECHELLE LAVETTE SAMUEL (AGENCY DIRECTOR)
(336) 624-5604
Entity
Organization
Contact information
Practice address
1001 S MARSHALL ST, WINSTON SALEM, NC 27101-5852
(336) 624-5604
Mailing address
1001 S MARSHALL ST, WINSTON SALEM, NC 27101-5852
(336) 624-5604
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408590
—
NC
Enumeration date
08/17/2007
Last updated
08/17/2007
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