Organization
NEW REVELATION HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE MICHELLE HAWKINS (ADMINISTRATOR)
(910) 500-9043
Entity
Organization
Contact information
Practice address
1500 BRAGG BLVD STE 104, FAYETTEVILLE, NC 28301-4289
(910) 500-9043
Mailing address
4226 RACCOON PATH, FAYETTEVILLE, NC 28312-9369
(910) 500-9043
(910) 500-3012
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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