Provider Demographics
NPI:1235284555
Name:LIFEFORCE HOME HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:LIFEFORCE HOME HEALTH SOLUTIONS, LLC
Other - Org Name:LIFEFORCE HHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALES-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-922-2219
Mailing Address - Street 1:7270 REYNOLDA RD
Mailing Address - Street 2:ONE REYNOLDA CENTRE
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-9759
Mailing Address - Country:US
Mailing Address - Phone:336-922-2219
Mailing Address - Fax:336-923-2144
Practice Address - Street 1:4735 YADKINVILLE RD
Practice Address - Street 2:FORSYTH CENTRE
Practice Address - City:PFAFFTOWN
Practice Address - State:NC
Practice Address - Zip Code:27040-9252
Practice Address - Country:US
Practice Address - Phone:336-924-0451
Practice Address - Fax:336-924-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3680251B00000X, 253Z00000X, 372500000X, 372600000X, 374700000X, 3747A0650X, 3747P1801X, 376J00000X, 376K00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418521Medicaid
NC6601685Medicaid