Organization Name: | HERITAGE HOME CARE OF CHARLOTTE |
NPI Number: | 1659616985 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICO A WAGNER (DIRECTOR) |
Mailing Address: | 3800 Monroe Rd Charlotte |
State: | NC US |
Postal Code: | 282057758 |
Phone Number: | 7043724210 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2012 |
NPI Last Update Date: | 07/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |