Provider Demographics
NPI:1902134133
Name:METROLINA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:METROLINA HOME HEALTH CARE LLC
Other - Org Name:HOME HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:704-707-0575
Mailing Address - Street 1:8410 PIT STOP COURT, SUITE 125
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8258
Mailing Address - Country:US
Mailing Address - Phone:704-707-0575
Mailing Address - Fax:704-353-7099
Practice Address - Street 1:8410 PIT STOP COURT, SUITE 125
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8258
Practice Address - Country:US
Practice Address - Phone:704-707-0575
Practice Address - Fax:704-353-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3933251E00000X
HC3933251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care