Provider Demographics
NPI:1881728152
Name:CAROLINAS HOME CARE AGENCY, INC.
Entity type:Organization
Organization Name:CAROLINAS HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:910-642-3700
Mailing Address - Street 1:603 S CANAL ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4256
Mailing Address - Country:US
Mailing Address - Phone:910-642-3700
Mailing Address - Fax:
Practice Address - Street 1:603 S CANAL ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4256
Practice Address - Country:US
Practice Address - Phone:910-642-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 251B00000X, 251E00000X, 251S00000X
NCMHL-024-077251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8703164Medicaid
NC3408684Medicaid
NC5904080Medicaid
NC8302157Medicaid
NC8302149Medicaid
NC8702279Medicaid
NC8301177Medicaid
NC6600413Medicaid
ND8702278Medicaid