Organization
SPC HOME HEALTH LLC
Active
Parent organization
SPC HOME HEALTH LLC
Other names
SPC Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPC HOME HEALTH LLC
Authorized official
MS. SHAKISHA NICOLE BREWINGTON (OWNER/BUSINESS MANAGER)
(910) 658-8525
Entity
Organization
Contact information
Practice address
4910 RANDALL PKWY, WILMINGTON, NC 28403-2827
(910) 395-8039
(910) 395-8381
Mailing address
PO BOX 3385, WILMINGTON, NC 28406-0385
(910) 395-8039
(910) 395-8381
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4101
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6602388
—
NC
Enumeration date
09/04/2013
Last updated
09/04/2013
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