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Organization

PERSONAL HOME CARE OF NORTH CAROLINA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVAN BELOV (DIRECTOR)
(704) 522-6144
Entity
Organization

Contact information

Practice address
111B N HOFFMAN ST, DALLAS, NC 28034-1597
(704) 522-6144
(704) 522-6145
Mailing address
1515 MOCKINGBIRD LN STE 520, CHARLOTTE, NC 28209-3297
(704) 522-6144
(704) 522-6145

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
HC2481
NC
253Z00000X
In Home Supportive Care Agency
Primary
HC2481
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100607
NC
Enumeration date
09/24/2007
Last updated
02/28/2026
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