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CAROLINA VILLAGE COMMUNITY CARE LLC NPI 1578276135


NPI Information

NPI: 1578276135
Provider Name: CAROLINA VILLAGE COMMUNITY CARE, LLC
Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization

CLIA Number: 34D2276459

Address:
1122 SAM NEWELL RD STE 103
MATTHEWS, NC
ZIP 28105
Phone: (704) 625-6598
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CAROLINA VILLAGE COMMUNITY CARE, LLC is an in home supportive care in Matthews, NC. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. CAROLINA VILLAGE COMMUNITY CARE, LLC NPI is 1578276135. The provider is registered as an organization entity type.

The provider's business location address is:

1122 SAM NEWELL RD STE 103
MATTHEWS, NC
ZIP 28105-016
Phone: (704) 625-6598

The provider's authorized official is Kendra Johnson .
The authorized official title is Owner and has the following contact phone number (704) 625-6598.

The CLIA number assigned to this NPI record is 34D2276459 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/28/2022 and was last updated on 9/14/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251E00000XHome HealthNo
2251S00000XCommunity/Behavioral HealthNo
3343900000XNon-emergency Medical Transport (VAN)No
4347C00000XPrivate VehicleNo
5385H00000XRespite CareNo
6385HR2055XRespite CareRespite Care, Mental Illness, ChildNo
7385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
8385HR2065XRespite CareRespite Care, Physical Disabilities, ChildNo
9343800000XSecured Medical Transport (VAN)No
10253Z00000XIn Home Supportive CareYes

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: 5/5/2024

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.