Organization
LOGO HOME CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PATRICK FUNDERBURK (OWNER)
(704) 712-1221
Entity
Organization
Contact information
Practice address
5513 MONROE RD STE 207, CHARLOTTE, NC 28212-5503
(704) 712-1221
(704) 529-6889
Mailing address
5513 MONROE RD STE 207, CHARLOTTE, NC 28212-5503
(704) 712-1221
(704) 537-7531
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6602212
—
NC
Enumeration date
11/17/2010
Last updated
05/07/2013
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