Provider Demographics
NPI:1902236961
Name:ENHANCEMENT HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ENHANCEMENT HEALTH CARE, INC.
Other - Org Name:CARE HEALTH SERVICES #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-6600
Mailing Address - Street 1:2402 S MIAMI BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4928
Mailing Address - Country:US
Mailing Address - Phone:919-479-6600
Mailing Address - Fax:919-479-1010
Practice Address - Street 1:2801 DARROW RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2417
Practice Address - Country:US
Practice Address - Phone:919-479-6600
Practice Address - Fax:919-479-1010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENHANCEMENT HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-12
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-032-407305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1902236961OtherNPI
NC7806027Medicaid