Provider Demographics
NPI:1053625830
Name:BAILEY HOME HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:BAILEY HOME HEALTH CARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TASHOMBI
Authorized Official - Middle Name:AZECKRY
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-399-3465
Mailing Address - Street 1:4701 WRIGHTSVILLE AVE STE 2-105
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6933
Mailing Address - Country:US
Mailing Address - Phone:910-399-3465
Mailing Address - Fax:800-915-0237
Practice Address - Street 1:4701 WRIGHTSVILLE AVE STE 2-105
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6933
Practice Address - Country:US
Practice Address - Phone:910-399-3465
Practice Address - Fax:800-915-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4147251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1750617767OtherAPPLY FOR NPI