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Organization

WSH CAP SERVICES

Active
Parent organization
WHITE SWAN HOME HEALTH LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
WHITE SWAN HOME HEALTH LLC
Authorized official
MR. JOHNATHAUN LEE (BUSINESS MANAGER)
(954) 479-9856
Entity
Organization

Contact information

Practice address
603 EASTCHESTER DR, SUITE D, HIGH POINT, NC 27262-7673
(910) 242-9006
Mailing address
PO BOX 260714, PEMBROKE PINES, FL 33026-7714
(910) 242-9006

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4238
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418949
NC
Enumeration date
05/17/2013
Last updated
05/17/2013
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