Organization
PROFESSIONAL CARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESIA MEDLEY MSW (ADMINISTRATOR)
(704) 536-7326
Entity
Organization
Contact information
Practice address
2070 CLOVERDALE AVE., SUITE C, WINSTON-SALEM, NC 27103
(336) 725-0755
Mailing address
2070 CLOVERDALE AVE., SUITE C, WINSTON-SALEM, NC 27103
(336) 725-0755
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HC2948
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601252
—
NC
Enumeration date
01/22/2007
Last updated
08/22/2020
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