Provider Demographics
NPI:1629954763
Name:ARDEBELLA HOME SERVICES
Entity type:Organization
Organization Name:ARDEBELLA HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHIBOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIBOR
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:336-988-6143
Mailing Address - Street 1:1952 KIPPEN DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9953
Mailing Address - Country:US
Mailing Address - Phone:336-988-6143
Mailing Address - Fax:
Practice Address - Street 1:1952 KIPPEN DR
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-9953
Practice Address - Country:US
Practice Address - Phone:336-988-6143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities