Organization
HARRY O HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNISHA ASHAKI MCPHAUL (CEO/DIRECTOR)
(704) 737-5829
Entity
Organization
Contact information
Practice address
5736 N TRYON ST STE 225A, CHARLOTTE, NC 28213-0820
(980) 888-2214
Mailing address
4504 ROLLING HILL DR APT C17, CHARLOTTE, NC 28213-6783
(704) 737-5829
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
372600000X
Adult Companion
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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