Provider Demographics
NPI:1447074323
Name:DEVOTED EXPRESSION HOMECARE LLC
Entity type:Organization
Organization Name:DEVOTED EXPRESSION HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVIAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-438-1271
Mailing Address - Street 1:156 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-8414
Mailing Address - Country:US
Mailing Address - Phone:704-438-1271
Mailing Address - Fax:
Practice Address - Street 1:107 E WADE ST STE C107E
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2277
Practice Address - Country:US
Practice Address - Phone:704-438-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care