Organization
MGA HOME HEALTHCARE FAYETTEVILLE, LLC
Active
Other names
MGA Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
MELODY BEATY (VP CLINICAL OPERATIONS)
(704) 200-9015
Entity
Organization
Contact information
Practice address
4700 HOMEWOOD CT STE 310, RALEIGH, NC 27609-5732
(919) 241-7781
Mailing address
4700 HOMEWOOD CT STE 310, RALEIGH, NC 27609-5732
(919) 241-7781
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
05
—
HC6297
—
NC
Enumeration date
04/07/2021
Last updated
11/30/2023
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