Provider Demographics
NPI:1174855977
Name:HEARTWINGS HIGHTS
Entity Type:Organization
Organization Name:HEARTWINGS HIGHTS
Other - Org Name:HOMEWATCH CAREGIVERS SERVING THE PIEDMONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-455-9967
Mailing Address - Street 1:3200 NORTHLINE AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7616
Mailing Address - Country:US
Mailing Address - Phone:336-455-9967
Mailing Address - Fax:336-455-9888
Practice Address - Street 1:3200 NORTHLINE AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7616
Practice Address - Country:US
Practice Address - Phone:336-455-9967
Practice Address - Fax:336-455-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3988253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care