Individual
CLOTELEOUS RUSH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1631 MIDTOWN PL STE 116, RALEIGH, NC 27609-1300
(984) 289-8602
Mailing address
1631 MIDTOWN PL STE 116, RALEIGH, NC 27609-1300
(984) 289-8602
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
253Z00000X
In Home Supportive Care Agency
Primary
HC6416
NC
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/10/2022
Last updated
01/09/2024
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