Provider Demographics
NPI:1780566455
Name:CENTRE CARE NURSING SERVICES
Entity type:Organization
Organization Name:CENTRE CARE NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUENISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTWAY-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:334-419-4302
Mailing Address - Street 1:6737 VOLZ CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2113
Mailing Address - Country:US
Mailing Address - Phone:334-419-4302
Mailing Address - Fax:
Practice Address - Street 1:6737 VOLZ CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2113
Practice Address - Country:US
Practice Address - Phone:334-419-4302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRE CARE NURSING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health