Individual
JOAN H HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGENCY DIRECTOR
Contact information
Practice address
1213 GOSHEN ST, SUITE B, OXFORD, NC 27565-9313
(919) 603-0661
(919) 603-1661
Mailing address
1213 GOSHEN ST, SUITE B, OXFORD, NC 27565-9313
(919) 603-0661
(919) 603-1661
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
HC4295
NC
251J00000X
Nursing Care Agency
HC4295
NC
253Z00000X
In Home Supportive Care Agency
Primary
HC4295
NC
3747P1801X
Personal Care Attendant
HC4295
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC4296
HOME CARE SERVICES NC DHHS DIVISION OF HEALTH SERVICES REGULATIONS
NC
Enumeration date
02/17/2011
Last updated
09/03/2013
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