Provider Demographics
NPI:1700259090
Name:VISITING ANGELS OF CENTRAL NORTH CAROLINA, INC.
Entity type:Organization
Organization Name:VISITING ANGELS OF CENTRAL NORTH CAROLINA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSSEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-968-3724
Mailing Address - Street 1:368 DEER PATH
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-5094
Mailing Address - Country:US
Mailing Address - Phone:919-968-3724
Mailing Address - Fax:
Practice Address - Street 1:104 JONES FERRY RD
Practice Address - Street 2:SUITE A
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2036
Practice Address - Country:US
Practice Address - Phone:919-968-3724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2782251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health