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Organization

PROFESSIONAL CARE HOME HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESIA MEDLEY (ADMINISTRATOR)
(704) 536-7326
Entity
Organization

Contact information

Practice address
3137 AMITY COURT, SUITE 400, CHARLOTTE, NC 28215
(704) 536-7326
(704) 536-7147
Mailing address
3137 AMITY COURT, SUITE 400, CHARLOTTE, NC 28215
(704) 536-7326
(704) 536-7147

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
0000000
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1234567
PDN
NC
Enumeration date
10/16/2008
Last updated
10/16/2008
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