Organization
AT HOME PERSONAL CARE SERVICES,INC. OF NORTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGENIA LYNELLE GILLIAM RN (OWNER)
(252) 321-9300
Entity
Organization
Contact information
Practice address
204 E ARLINGTON BLVD, SUITE M, GREENVILLE, NC 27858-5022
(252) 321-9300
(252) 321-9390
Mailing address
204 E ARLINGTON BLVD, SUITE M, GREENVILLE, NC 27858-5022
(252) 321-9300
(252) 321-9390
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2818
NC
251E00000X
Home Health Agency
HC3608
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418065
—
NC
05
—
6006787
—
NC
05
—
6601431
—
NC
05
—
8301812
—
NC
Enumeration date
02/07/2007
Last updated
01/19/2011
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