Provider Demographics
NPI:1144365057
Name:OPEN HANDS CAREGIVER SERVICES, INC.
Entity type:Organization
Organization Name:OPEN HANDS CAREGIVER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:CASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:336-789-2944
Mailing Address - Street 1:PO BOX 1192
Mailing Address - Street 2:
Mailing Address - City:TOAST
Mailing Address - State:NC
Mailing Address - Zip Code:27049-1192
Mailing Address - Country:US
Mailing Address - Phone:336-789-2944
Mailing Address - Fax:336-786-1834
Practice Address - Street 1:223 INGRAM DR
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8206
Practice Address - Country:US
Practice Address - Phone:336-985-0871
Practice Address - Fax:336-985-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3683251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601694Medicaid