Organization
CAROLINA PERSONAL CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN ALICE MOORE RN (DIRECTOR RN)
(910) 590-2480
Entity
Organization
Contact information
Practice address
919 ROWAN RD, CLINTON, NC 28328-0872
(910) 590-2480
(910) 592-2718
Mailing address
919 ROWAN RD, CLINTON, NC 28328-0872
(910) 590-2480
(910) 592-2718
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HC2980
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601295
—
NC
Enumeration date
01/12/2007
Last updated
08/22/2020
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