Organization
PROFESSIONAL CARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. Y'LONDA JACKSON (OFFICE MANAGER)
(336) 725-0755
Entity
Organization
Contact information
Practice address
3721 EASTWAY DR, CHARLOTTE, NC 28205-6266
(704) 536-7326
(704) 536-7147
Mailing address
2070 CLOVERDALE AVE, SUITE C, WINSTON-SALEM, NC 27103-2503
(336) 725-0755
(336) 725-0756
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
00000
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8700474
—
NC
Enumeration date
05/16/2008
Last updated
05/16/2008
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