Provider Demographics
NPI:1942349279
Name:CENTRAL HOME HEALTH INC.
Entity type:Organization
Organization Name:CENTRAL HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KANISHA
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:DICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-225-0167
Mailing Address - Street 1:2141 EAST GEER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-794-7266
Mailing Address - Fax:919-439-0222
Practice Address - Street 1:2141 EAST GEER ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-794-7266
Practice Address - Fax:919-439-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1172251E00000X
251E00000X, 251F00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6800246Medicaid
NC944279Medicaid
NC3408553Medicaid
NC87700240Medicaid
NC6600275Medicaid
NC7202537Medicaid
NC7701440Medicaid