Provider Demographics
NPI:1356920516
Name:JONES, TASHA L (MBA, MHA, CEO)
Entity type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:MBA, MHA, CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-0601
Mailing Address - Country:US
Mailing Address - Phone:919-802-7954
Mailing Address - Fax:
Practice Address - Street 1:232 E CHATHAM ST STE 101
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3459
Practice Address - Country:US
Practice Address - Phone:919-802-7954
Practice Address - Fax:919-300-5600
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHCS5740385H00000X, 253Z00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care