| Organization Name: | LOGO HOME CARE SERVICES, LLC |
| NPI Number: | 1649572082 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID PATRICK FUNDERBURK (OWNER) |
| Mailing Address: | 5513 Monroe Rd Ste 207 Charlotte |
| State: | NC US |
| Postal Code: | 282125503 |
| Phone Number: | 7047121221 |
| Fax Number: | 7045296889 |
| NPI Enumeration Date: | 11/17/2010 |
| NPI Last Update Date: | 05/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | HC4230 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |