Provider Demographics
NPI:1528493749
Name:NEVERS HOME HEALTHCARE AGENCY, INC
Entity type:Organization
Organization Name:NEVERS HOME HEALTHCARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREDISENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL ASSISTANCE
Authorized Official - Phone:910-229-6728
Mailing Address - Street 1:3921 COLORADO DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2167
Mailing Address - Country:US
Mailing Address - Phone:910-229-6728
Mailing Address - Fax:910-864-1123
Practice Address - Street 1:3921 COLORADO DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-2167
Practice Address - Country:US
Practice Address - Phone:910-229-6728
Practice Address - Fax:910-864-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1689723801Medicaid
NCHC3601Medicaid
NC3418287Medicaid
NC6601653Medicaid