Organization
MGA HOME HEALTHCARE FAYETTEVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY CHAVEZ MSN, RN (VP, OPERATIONS)
(910) 839-0239
Entity
Organization
Contact information
Practice address
3400 WALSH PKWY STE 248, FAYETTEVILLE, NC 28311-1642
(910) 839-0239
(910) 900-0915
Mailing address
3400 WALSH PKWY STE 248, FAYETTEVILLE, NC 28311-1642
(910) 839-0239
(910) 900-0915
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC6297
—
NC
Enumeration date
03/02/2022
Last updated
03/02/2022
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