Provider Demographics
NPI:1427292309
Name:HAZEL'S HOME CARE SOLUTIONS
Entity type:Organization
Organization Name:HAZEL'S HOME CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIMISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-342-3031
Mailing Address - Street 1:707 PIEDMONT ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-3623
Mailing Address - Country:US
Mailing Address - Phone:336-349-4887
Mailing Address - Fax:336-342-1918
Practice Address - Street 1:820 CRUTCHFIELD RD
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-8265
Practice Address - Country:US
Practice Address - Phone:336-349-4887
Practice Address - Fax:336-342-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL 079 074261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care