Provider Demographics
NPI:1225382385
Name:CAROLINA HOMECARE VENTURES, LLC
Entity type:Organization
Organization Name:CAROLINA HOMECARE VENTURES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMENIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-661-5686
Mailing Address - Street 1:11330 VANSTORY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-8143
Mailing Address - Country:US
Mailing Address - Phone:704-897-0496
Mailing Address - Fax:704-897-0544
Practice Address - Street 1:11330 VANSTORY DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-8143
Practice Address - Country:US
Practice Address - Phone:704-897-0496
Practice Address - Fax:704-897-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-28
Last Update Date:2012-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care