Provider Demographics
NPI:1003688136
Name:HIGH COTTON HOMES, LLC
Entity Type:Organization
Organization Name:HIGH COTTON HOMES, LLC
Other - Org Name:HIGH COTTON HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-268-4446
Mailing Address - Street 1:307 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:GA
Mailing Address - Zip Code:31092-7543
Mailing Address - Country:US
Mailing Address - Phone:229-268-4446
Mailing Address - Fax:229-268-4447
Practice Address - Street 1:307 CHARLES ST
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:GA
Practice Address - Zip Code:31092-7543
Practice Address - Country:US
Practice Address - Phone:229-268-4446
Practice Address - Fax:229-268-4447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH COTTON HOMES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-23
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility