Provider Demographics
NPI:1124586771
Name:CAROLINA HOME ADVANTAGE, LLC
Entity type:Organization
Organization Name:CAROLINA HOME ADVANTAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHASITI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-561-3897
Mailing Address - Street 1:1033 RANDOLPH ST STE 14
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-5731
Mailing Address - Country:US
Mailing Address - Phone:336-973-8850
Mailing Address - Fax:336-973-3052
Practice Address - Street 1:1033 RANDOLPH ST STE 14
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5731
Practice Address - Country:US
Practice Address - Phone:336-973-8850
Practice Address - Fax:336-973-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-02
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care