Provider Demographics
NPI:1922817055
Name:101 HOME CARE AGENCY
Entity type:Organization
Organization Name:101 HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:MARGERET
Authorized Official - Last Name:AKOBUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-641-4922
Mailing Address - Street 1:2504 HOLBROOK CT STE 400
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-8414
Mailing Address - Country:US
Mailing Address - Phone:919-641-4922
Mailing Address - Fax:
Practice Address - Street 1:8601 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5276
Practice Address - Country:US
Practice Address - Phone:919-587-1808
Practice Address - Fax:919-238-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care