Provider Demographics
NPI:1003984865
Name:APPALACHIAN HOME CARE LLC
Entity Type:Organization
Organization Name:APPALACHIAN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:828-963-8233
Mailing Address - Street 1:7929 NC HIGHWAY 105 S
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8015
Mailing Address - Country:US
Mailing Address - Phone:828-963-8233
Mailing Address - Fax:828-963-7375
Practice Address - Street 1:7929 NC HIGHWAY 105 S
Practice Address - Street 2:SUITE B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8015
Practice Address - Country:US
Practice Address - Phone:828-963-8233
Practice Address - Fax:828-963-7375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2391163W00000X, 164W00000X, 251E00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601038Medicaid
NC7100520Medicaid
NC6600980Medicaid
NC7100500Medicaid
NC3409570Medicaid