Organization
PROFESSIONAL CARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESIA M MEDLEY MSW (ADMINISTRATOR)
(704) 536-7326
Entity
Organization
Contact information
Practice address
3126 MILTON RD, SUITE 217, CHARLOTTE, NC 28215-3778
(704) 536-7326
(704) 536-7147
Mailing address
3126 MILTON RD, SUITE 217, CHARLOTTE, NC 28215-3778
(704) 536-7326
(704) 536-7147
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601390
—
NC
Enumeration date
07/23/2006
Last updated
08/22/2020
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