Organization
PRISTINE CARE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOVAN LATOYA BOWSER (COO)
(910) 302-8455
Entity
Organization
Contact information
Practice address
1507 GRANDVIEW DRIVE, FAYETTEVILLE, NC 28314-1806
(910) 302-8455
Mailing address
1507 GRANDVIEW DR, FAYETTEVILLE, NC 28314-1806
(910) 302-8455
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
332U00000X
Home Delivered Meals
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
Update your record
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