Organization
A FULFILLED VISION HOME HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANATA CRAWFORD (CEO)
(704) 349-3892
Entity
Organization
Contact information
Practice address
128 E GARRISON BLVD STE B, GASTONIA, NC 28054-0421
(704) 691-7540
Mailing address
128 E GARRISON BLVD STE B, GASTONIA, NC 28054-0421
(704) 691-7540
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3836
NC
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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