Organization
PROFESSIONAL CARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESIA MEDLEY MSW (ADMINISTRATOR)
(704) 536-7326
Entity
Organization
Contact information
Practice address
3126 MILTON RD, SUITE 217, CHARLOTTE, NC 28215-3778
(704) 536-7326
(704) 536-7147
Mailing address
3126 MILTON RD, SUITE 217, CHARLOTTE, NC 28215-3778
(704) 536-7326
(704) 536-7147
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
NC
Enumeration date
02/06/2007
Last updated
08/22/2020
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