Provider Demographics
NPI:1215646518
Name:AMEN HOME CARE SERVICES
Entity type:Organization
Organization Name:AMEN HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:EZEKWE-ANYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-390-6466
Mailing Address - Street 1:2750 E W T HARRIS BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4367
Mailing Address - Country:US
Mailing Address - Phone:170-439-0646
Mailing Address - Fax:
Practice Address - Street 1:2750 E W T HARRIS BLVD STE 208
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4367
Practice Address - Country:US
Practice Address - Phone:170-439-0646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care