Provider Demographics
NPI:1457578064
Name:TRUE LOVE HOME CARE AGENCY
Entity type:Organization
Organization Name:TRUE LOVE HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:RN
Authorized Official - Phone:252-321-1997
Mailing Address - Street 1:299 FOXCROFT LANE
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8666
Mailing Address - Country:US
Mailing Address - Phone:252-321-1997
Mailing Address - Fax:
Practice Address - Street 1:299 FOXCROFT LANE
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8666
Practice Address - Country:US
Practice Address - Phone:252-321-1997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3209251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601402Medicaid