Organization
AUTUMN OAK HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON W MAINES (PRESIDENT)
(336) 667-3007
Entity
Organization
Contact information
Practice address
915 MAIN ST, 105 PARK PLACE, NORTH WILKESBORO, NC 28659-4254
(336) 667-3007
Mailing address
915 MAIN ST, 105 PARK PLACE, NORTH WILKESBORO, NC 28659-4254
(336) 667-3007
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2109
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409637
—
NC
05
—
6601028
—
NC
Enumeration date
01/15/2007
Last updated
07/11/2011
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