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PROFESSIONAL CARE HOME HEALTH SERVI NPI 1467505305


NPI Information

NPI: 1467505305
Provider Name: PROFESSIONAL CARE HOME HEALTH SERVI
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization
Address:
2070 CLOVERDALE AVE
SUITE C
WINSTON-SALEM, NC
ZIP 27103
Phone: (336) 725-0755
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PROFESSIONAL CARE HOME HEALTH SERVI is a case manager care coordinator in Winston-salem, NC. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. PROFESSIONAL CARE HOME HEALTH SERVI NPI is 1467505305. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2070 CLOVERDALE AVE
SUITE C
WINSTON-SALEM, NC
ZIP 27103
Phone: (336) 725-0755

The provider's authorized official is Teresia Medley .
The authorized official title is Administrator and has the following contact phone number (336) 725-0755.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 6/25/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18700436MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.