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Organization

COMPANION HOME CARE UNIMED INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES VINSON GRAHAM (OWNER)
(910) 608-0430
Entity
Organization

Contact information

Practice address
4820 FAYETTEVILLE RD, LUMBERTON, NC 28358-2112
(910) 608-0430
(910) 608-0464
Mailing address
4820 FAYETTEVILLE RD, LUMBERTON, NC 28358-2112
(910) 608-0430
(910) 608-0464

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL078162
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300603R
NC
Enumeration date
02/06/2007
Last updated
02/04/2009
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