Organization
WELL CARE HOME HEALTH OF THE TRIANGLE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MOORE (DIRECTOR OF REVENUE CYCLE)
(910) 362-9405
Entity
Organization
Contact information
Practice address
5400 GLENWOOD AVE STE 310, RALEIGH, NC 27612-3148
(919) 846-1018
(919) 846-5954
Mailing address
131 RACINE DR STE 201, WILMINGTON, NC 28403-8752
(910) 362-9405
(910) 202-1376
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC0074
NC
251J00000X
Nursing Care Agency
HC0074
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009E1
PRIVATE DUTY NURSING-BCBS
NC
05
—
3417192
—
NC
01
—
7100623
PRIVATE DUTY - MEDICAID
NC
Enumeration date
02/01/2011
Last updated
06/28/2024
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