Provider Demographics
NPI:1922670850
Name:CAROLINA CARE PROVIDERS INC
Entity type:Organization
Organization Name:CAROLINA CARE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FONEBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-724-6472
Mailing Address - Street 1:1856 AUSTIN RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-1899
Mailing Address - Country:US
Mailing Address - Phone:919-724-6472
Mailing Address - Fax:
Practice Address - Street 1:4826A WINDY HILL DRIVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-2760
Practice Address - Country:US
Practice Address - Phone:919-724-6472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health