Provider Demographics
NPI:1871716076
Name:CAROLINA REGIONAL HOMECARE
Entity type:Organization
Organization Name:CAROLINA REGIONAL HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-659-5636
Mailing Address - Street 1:45 EARL LEE RD
Mailing Address - Street 2:
Mailing Address - City:NEBO
Mailing Address - State:NC
Mailing Address - Zip Code:28761-9560
Mailing Address - Country:US
Mailing Address - Phone:828-659-5636
Mailing Address - Fax:828-652-1886
Practice Address - Street 1:45 EARL LEE RD
Practice Address - Street 2:
Practice Address - City:NEBO
Practice Address - State:NC
Practice Address - Zip Code:28761-9560
Practice Address - Country:US
Practice Address - Phone:828-659-5636
Practice Address - Fax:828-652-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2248251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600891Medicaid