Provider Demographics
NPI:1255921219
Name:STEPHANIE HOME CARE & HOMESTYLE COOKING, LLC.
Entity type:Organization
Organization Name:STEPHANIE HOME CARE & HOMESTYLE COOKING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-977-8846
Mailing Address - Street 1:1924 WINGET ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-7691
Mailing Address - Country:US
Mailing Address - Phone:704-977-8846
Mailing Address - Fax:
Practice Address - Street 1:4316 W ARGYLE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6169
Practice Address - Country:US
Practice Address - Phone:704-977-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty