Organization · Type 2 NPI

Kween5464 Corporation

In Home Supportive Care Agency · Winston Salem, NC

NPI number 1912535097 Active

Practice location

1826 E 4th St
Winston Salem, NC 27101-4606

Call (336) 582-9156 Map

Fax (888) 682-1348

Mailing address

PO Box 561
Winston Salem, NC 27102-0561

Specialties and licenses

Taxonomy	Code	License
In Home Supportive Care Agency Primary	253Z00000X	None listed

In Home Supportive Care Agency: 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 medicatio…

Other in home supportive care agency providers in Winston Salem

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NPI record

NPI: 1912535097
Entity type: Organization (Type 2)
Issued: Apr 1, 2020
Last updated: Aug 9, 2021
Status: Active
Subpart: Yes of Kween5464 Corporation

Other names

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At Home Eldercare of Winston Salem · doing business as
At Home Eldercare of Winston Salem · doing business as

Authorized official

Ms. Kimberly Pettigrew
Owner/director
(336) 582-9156

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1912535097

Kween5464 Corporation's National Provider Identifier is 1912535097, issued on Apr 1, 2020. The primary taxonomy on file is In Home Supportive Care Agency (253Z00000X), and the practice location is in Winston Salem, NC. The record was last updated on Aug 9, 2021.