Organization
GENESIS OF CAROLINAS HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OCTAVIA DEVONNE SHANKLE (OWNER/DIRECTOR)
(980) 207-3947
Entity
Organization
Contact information
Practice address
5736 NORTH TRYON STREET SUITE 128, CHARLOTTE, NC 28213-6891
(980) 207-3947
(980) 207-3956
Mailing address
5736 NORTH TRYON STREET SUITE 128, CHARLOTTE, NC 28213-6891
(980) 207-3947
(980) 207-3956
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
100027
NC
Other
Enumeration date
08/28/2009
Last updated
08/01/2019
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