Provider Demographics
NPI:1427342021
Name:DEDICATED HOME SERVICES
Entity type:Organization
Organization Name:DEDICATED HOME SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-658-0555
Mailing Address - Street 1:631 BRAWLEY SCHOOL ROAD
Mailing Address - Street 2:STE 300 PMB 227
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6212
Mailing Address - Country:US
Mailing Address - Phone:704-658-0555
Mailing Address - Fax:866-238-8409
Practice Address - Street 1:425 E STATESVILLE AVE STE 101
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2533
Practice Address - Country:US
Practice Address - Phone:704-658-0555
Practice Address - Fax:866-238-8409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health