Organization
MGA HOME HEALTHCARE FAYETTEVILLE, LLC
Active
Other names
MGA Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY CHAVEZ MSN, RN (VP, OPERATIONS)
(704) 200-9015
Entity
Organization
Contact information
Practice address
1100 SOUTH STRATFORD RD, BLDG C SUITE 301, WINSTON-SALEM, NC 27103
(336) 280-0435
(336) 217-8746
Mailing address
1100 SOUTH STRATFORD RD, BLDG C SUITE 301, WINSTON-SALEM, NC 27103
(336) 280-0435
(336) 217-8746
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC6067
—
NC
05
—
HC6135
—
NC
Enumeration date
03/02/2022
Last updated
03/02/2022
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