Provider Demographics
NPI:1548546534
Name:CARE ONE HOMES NC
Entity type:Organization
Organization Name:CARE ONE HOMES NC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ANUMUDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-637-9441
Mailing Address - Street 1:4921 KNIGHTSBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4894
Mailing Address - Country:US
Mailing Address - Phone:919-637-9441
Mailing Address - Fax:
Practice Address - Street 1:926 EDISON RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3764
Practice Address - Country:US
Practice Address - Phone:919-212-3705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness