Provider Demographics
NPI:1063537546
Name:CAROLINA ANGELS HOME CARE INC
Entity type:Organization
Organization Name:CAROLINA ANGELS HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SERVICE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BRATHWAITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-523-1040
Mailing Address - Street 1:756 TYVOLA RD STE 143
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-8217
Mailing Address - Country:US
Mailing Address - Phone:704-523-1040
Mailing Address - Fax:704-523-1080
Practice Address - Street 1:756 TYVOLA RD STE 143
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-8217
Practice Address - Country:US
Practice Address - Phone:704-523-1040
Practice Address - Fax:704-523-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC193729163WH0200X
NC193728251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty