Provider Demographics
NPI:1588871305
Name:BONDING LIVES HOME CARE AGENCY INC
Entity type:Organization
Organization Name:BONDING LIVES HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-903-4459
Mailing Address - Street 1:1206 SUMMERFIELD LN E
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1206 SUMMERFIELD LN E
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522
Practice Address - Country:US
Practice Address - Phone:252-767-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3168251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601384Medicaid