Provider Demographics
NPI:1114144524
Name:HOMEBORN HEALTH, P.L.L.C.
Entity Type:Organization
Organization Name:HOMEBORN HEALTH, P.L.L.C.
Other - Org Name:HOMEBORN HEALTH, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:WRZESINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED NURSE - MI
Authorized Official - Phone:815-218-0766
Mailing Address - Street 1:24 SNELSON DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-7416
Mailing Address - Country:US
Mailing Address - Phone:828-515-5227
Mailing Address - Fax:828-515-5227
Practice Address - Street 1:24 SNELSON DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-7416
Practice Address - Country:US
Practice Address - Phone:828-515-5227
Practice Address - Fax:828-515-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC286113163W00000X
IL209-003484251J00000X
IL209-003485251J00000X
NC634367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251J00000XAgenciesNursing Care