NEW REVELATION HOME CARE LLC (NPI# 1518576289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518576289 |
Entity Type | Organization |
Organization Name | NEW REVELATION HOME CARE LLC |
Practice Address |
1500 Bragg Blvd Ste 104 Fayetteville NC 28301-4289 |
Mailing Address |
4226 Raccoon Path Fayetteville NC 28312-9369 |
Practice Telephone | 9105009043 |
Mailing Telephone | 9105009043 |
Mailing Fax Number | 9105003012 |
Enumeration Date | 2020-07-28 |
Last Update Date | 2020-07-28 |
Authorized Official Name | KELLIE MICHELLE HAWKINS (ADMINISTRATOR) |
Authorized Official Telephone | 9105009043 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 253Z00000X | In Home Supportive Care | Agencies |
Street Address |
1500 BRAGG BLVD STE 104 |
City | FAYETTEVILLE |
State | NC |
Zip Code | 28301-4289 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
Find all providers in zip 28301 |
Taxonomy Code | 253Z00000X |
Grouping | Agencies |
Classification | In Home Supportive Care |
An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487252219 | Tera Campbell | In Home Supportive Care | 159 Dortmund Dr, Fayetteville, OH 45118-9406 | 2020-10-14 |
1568077485 | Pmp Home Care Agency Inc | In Home Supportive Care | 5329 Yadkin Rd Ste B, Fayetteville, NC 28303-3254 | 2020-09-09 |
1609481571 | Valley Care LLC | In Home Supportive Care | 2978 Cumberland Rd Ste 102, Fayetteville, NC 28306-2373 | 2020-09-08 |
1184236564 | Health & Home Services, Inc. | In Home Supportive Care | 2411 Robeson Street, Suite 100, Fayetteville, NC 28305-5577 | 2020-08-18 |
1609487487 | Living Private Home Care, LLC | In Home Supportive Care | 101 Devant St Ste 105a, Fayetteville, GA 30214-2711 | 2020-08-13 |
1063038792 | Dianna Marie Anderson | In Home Supportive Care | 101 Old Sandy Creek Rd Ste B, Fayetteville, GA 30214-4546 | 2020-06-18 |
1487279485 | A Clear Look Coaching Agency, LLC | In Home Supportive Care | 4582 Cumberland Rd Ste 104, Fayetteville, NC 28306-2416 | 2020-06-15 |
1679198899 | A Clear Look Coaching Agency, LLC | In Home Supportive Care | 910 Hay St, Fayetteville, NC 28305-5314 | 2020-06-12 |
1356965164 | Kedra Daniel | In Home Supportive Care | 435 Brenda Ln, Fayetteville, GA 30214-1505 | 2020-06-08 |
1932731700 | Light of The World Home Care LLC | In Home Supportive Care | 3069 Cumberland Rd Ste 104, Fayetteville, NC 28306-6819 | 2020-02-10 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 28301 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.