Organization
TABONO CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA LASHON CHISHOLM (MEMBER)
(704) 395-9496
Entity
Organization
Contact information
Practice address
3701 FREEDOM DR, CHARLOTTE, NC 28208-2205
(704) 395-9496
(866) 431-2587
Mailing address
PO BOX 480428, CHARLOTTE, NC 28269-5320
(704) 395-9496
(866) 431-2587
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4110
NC
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
HC4110
NC
376K00000X
Nurse's Aide
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497048417
—
NC
01
—
HC4110
STATE OF NORTH CAROLINA/DHHS-DHSR HOME CARE LICENSE
NC
Enumeration date
12/29/2008
Last updated
10/30/2023
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