Provider Demographics
NPI:1154966737
Name:CARE AT HOME HEALTH AGENCY
Entity type:Organization
Organization Name:CARE AT HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:828-774-7959
Mailing Address - Street 1:120 CHADWICK AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5710
Mailing Address - Country:US
Mailing Address - Phone:828-774-7959
Mailing Address - Fax:
Practice Address - Street 1:120 CHADWICK AVE STE 19
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5710
Practice Address - Country:US
Practice Address - Phone:828-774-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No347C00000XTransportation ServicesPrivate Vehicle