Organization
ST MARYS HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RASHAE N WILLIAMS BS (CEO)
(910) 433-4477
Entity
Organization
Contact information
Practice address
3401 VILLAGE DR, FAYETTEVILLE, NC 28304-4551
(910) 433-4477
(910) 920-3179
Mailing address
3401 VILLAGE DR, FAYETTEVILLE, NC 28304-4551
(910) 433-4477
(910) 920-3179
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0000
NC
251J00000X
Nursing Care Agency
HC2557
NC
251S00000X
Community/Behavioral Health Agency
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408108
—
NC
05
—
6601100
—
NC
05
—
8301378
—
NC
05
—
8302206
—
NC
05
—
8700445
—
NC
Enumeration date
11/01/2006
Last updated
12/23/2009
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